Bolu Abant İzzet Baysal Üniversitesi Nöroloji Kliniğinde Botulinum Toksin Uygulamaları Deneyimleri

Abstract

Amaç: Bu çalışmanın amacı, nöroloji klinik uygulamalarında uzun zamandır önemli yer tutan Botulinum Nörotoksin tip A(BoNT-A)'nın hemifasiyal spazm(HS), blefarospazm(BS), servikal distoni, bruksizm, baş tremoru gibi hareket hastalıklarıyla; inme, multiple skleroz(MS), spinal travma, herediter spastik parapleji(HSP) ve serebral palsi gibi farklı spastisite çeşitlerinde ve kronik migrende, uygulamalarının klinikteki etkilerini değerlendirmektir. Gereç ve Yöntemler: Bu retrospektif çalışmada, Ocak 2019 – Aralık 2021 tarihleri arasında kliniğimizde izlenen, aynı nörolog tarafından BoNT-A tedavileri uygulanan ve takip edilen;HS, BS, spastisite, servikal distoni, bruksizm,baş tremoru ve oral medikal tedaviye dirençli kronik migrenli, yaşları 21-85 arası 79 hastanın tanı ve tedavisi, tedavi doz ve uygulama şekilleri ile BoNT-A'ya verilen yanıtlar, tedavide sık görülen yan etkiler, tedavi süresince yapılan hasta takipleri ve hastalar tarafından subjektif olarak değerlendirilen tedaviye yanıtları, betimleyici istatistikler kullanılarak raporlanmış ve literatür eşliğinde tartışılmıştır. Bulgular: Hastaların, tedaviye yanıtlarındaki düzelme ilaç enjeksiyonundan yaklaşık bir ay sonra kontrol muayeneye geldiklerinde belirttikleri şekilde değerlendirildi. Hastalar, subjektif olarak %60 ve üzeri düzelmeyi iyi, %59-40 arası düzelmeyi orta, %39 ve altı düzelmeyi kötü olarak ifade etti. Buna göre hastaların %78,94'ü subjektif olarak iyileşmeyi iyi, % 13,15'i orta ve % 7,89 i kötü olarak belirtti. Komplikasyon insidansı % 9,21 olmasına rağmen bu yan etkiler tüm hastalarda hafif ve geçici olup hiçbir hastanın tedaviyi bırakmasına neden olmadı. Sonuç: Sonuçlar literatürle uyumlu olarak anlamlıydı. Bu çalışma, BoNT-A tedavisinin HS, BS, Servikal distoni, inme sonrası spastisite, serebral palsi, bruksizm, baş tremoru ve kronik migren için etkili ve güvenli bir tedavi olduğu gerçeğini desteklemektedir.

Keywords

• Botulinum toksini
• blefarospazm
• distoni
• hemifasiyal spazm
• spastisite

Botulinum Toxin Type A Application Experiences in Bolu Abant İzzet Baysal University Neurology Clinic

Abstract

Aim: The aim of this study was to evaluate the effects of different clinical applications of BoNT-A as hemifacial spasm, blepharospasm, cervical dystonia, bruxism, head tremor and spasticity in stroke, Multiple Sclerosis (MS), spinal trauma, hereditary spastic paraplegia, cerebral palsy, and chronic migraine. Material and Methods: In this retrospective study, which was conducted between January 2019 and December 2021, 79 patients with movement disorders, spasticity, and chronic migraine monitored in our clinic and whose BoNT-A injections were applied were included. The diagnosis and treatment, side effects encountered in therapy, follow-up during the treatment, and the response to the treatment evaluated subjectively by patients were discussed. Results: The improvement in patients' response to treatment was subjectively reported by themselves. The improvement in the response of the patients to the treatment subjectively stated that improvement of 60% and above was taken as good, improvement between 59-40% moderate, and improvement of 39% and below bad. Accordingly, 78.94% of the patients subjectively stated improvement as good, 13.15% as moderate, and 7.89% as bad. Although the incidence of complications was 9.21%, these side effects were mild and transient in all of the patients and did not cause any of the patients to discontinue the treatment. Conclusion: The results were statistically significant and consistent with the literature. This study supports the fact that botulinum toxin therapy is effective and safe for HS, BS, cervical dystonia, spasticity, bruxism, head tremor, and chronic migraine.

Keywords

• Botulinum Toxin
• blefpharospasm
• dystonia
• hemifacial spasm
• spasticity

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