Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty patients with blepharospasm, hemifacial spasm, strabismus and entropion were treated with botulinum A toxin giving satisfactory results. Rapid spasm relief, correction of strabismus and entropion were obtained. Only mild, transient and local side-effects occurred. The patients were followed up for 4-12 weeks with no recurrence. The clinical results show that local injection of a minute dose of botulinum A toxin in treating blepharospasm, hemifacial spasm, strabismus and entropion is a safe, effective and simple method of nonsurgical therapy.
 ...
PMID:Treatment of blepharospasm, hemifacial spasm and strabismus with botulinum a toxin. 145 48

We analyzed patients treated during the past five years with botulinum toxin type A for strabismus and blepharospasm, reviewed our successes, failures, and unusual cases, and drew conclusions based on these treatments. Thirty-seven percent of the strabismus patients were cured, but many patients who were outside the strict definitions, still believed that they were significantly improved. A prominent feature in the treatment of strabismus was variability. Frequently, patients expected to do poorly had encouraging results. One permanent overcorrection occurred, and it converted an esotopic patient into an exotropic one with diplopia. This has persisted for 2.5 years and is the longest reported overcorrection to our knowledge. Our results indicate that larger doses of botulinum toxin produce longer spasm-free intervals in the treatment of blepharospasm. One patient receiving injections for her blepharospasm discovered that its cause was her sedative medication. This is the first reported case of a benzodiazepine inducing blepharospasm to our knowledge.
 ...
PMID:A five-year analysis of botulinum toxin type A injections: some unusual features. 174 4

Botulinum A toxin has been used to treat strabismus and a variety of spasmodic neuromuscular diseases. Botulinum toxin treatment of strabismus is not as definitive and stable as the traditional surgical approach, but it has been found most useful in postoperative overcorrection, small deviations, sensory deviations, and acute sixth nerve palsy. This toxin has been effective in the treatment of essential blepharospasm and hemifacial spasm, for which it produces temporary relief of symptoms. In addition, this treatment has been applied to lower lid entropion, myokymia, aberrant regeneration of the seventh nerve, lid retraction, corneal exposure, nystagmus, spasmodic torticollis, and adductor spastic dysphonia.
 ...
PMID:Botulinum A toxin (Oculinum) in ophthalmology. 192 43

Botulinum toxin (BoTx) has been clinically used in the treatment of localized dystonic states such as blepharospasm, as well as in strabismus. Reported side effects have included primary excessive weakness of neighboring extraocular muscles. To evaluate possible involvement of the iris, we injected BoTx into the retrobular space of albino rats. Ipsilateral mydriasis with cholinomimetic supersensitivity developed in the treated animals. There was no apparent optic nerve dysfunction. The authors observed these effects using BoTx doses insufficient to cause clinical weakness or electrophysiological evidence of generalized neuromuscular dysfunction. The mydriasis disappeared spontaneously within 2-3 weeks. Higher BoTx doses resulted in severe neuromuscular paralysis and death. These findings were consistent with clinical botulism, which may include autonomic paralysis. The site of BoTx action could be the ciliary ganglion or cholinergic terminals in the iris. The authors concluded that side effects of BoTx were not necessarily limited to striated muscle weakness.
 ...
PMID:The pupillary effects of retrobulbar injection of botulinum toxin A (oculinum) in albino rats. 198 93

Botulinum toxin therapy has emerged as a treatment modality for a variety of spastic- or contracture-related muscle diseases. Its safety has been proven for long-term use in the treatment of benign essential blepharospasm, hemifacial spasm, and certain types of strabismus. Recent approval from the Federal Drug Administration should make botulinum toxin available for use in a greater number of patients.
 ...
PMID:Botulinum toxin therapy. 201 Nov 10

Botulinum A exotoxin was recently approved for use in Canada. We describe the efficacy of botulinum toxin in the management of 235 patients with blepharospasm (mean age 64.3 years) and 130 patients with hemifacial spasm (mean age 60.4 years) treated at three Canadian ophthalmologic centres between 1984 and 1989. A total of 98% of the patients with blepharospasm and 100% of the patients with hemifacial spasm had significant relief of their symptoms; however, 11% of the former and 2% of the latter did not respond to the usual starting concentrations of the drug and needed stronger dosages for relief. The duration of relief varied widely in both groups. Up to 7% of patients had ineffective treatments but responded to subsequent injections. Analysis of variance and linear trend statistics showed that there were no changes in the mean duration of relief over the first several treatments for individual patients in either group. Side effects were transient and included ptosis, exposure keratitis, epiphora and strabismus.
 ...
PMID:Treatment of blepharospasm and hemifacial spasm with botulinum A toxin: a Canadian multicentre study. 205 23

The National Institutes of Health Consensus Development Conference on Clinical Use of Botulinum Toxin brought together neurologists, ophthalmologists, otolaryngologists, speech pathologists, and other health care professionals as well as the public to address: the mechanisms of action of botulinum toxin, the indications and contraindications for botulinum toxin treatment, the general principles of technique of injection and handling for its safe and effective use, and the short-term and long-term side effects and complications of therapy. Following 2 days of presentations by experts and discussion by the audience, a consensus panel weighed the evidence and prepared their consensus statement. Among their findings, the panel recommended that (1) botulinum toxin therapy is safe and effective for treating strabismus, blepharospasm, hemifacial spasm, adductor spasmodic dysphonia, jaw-closing oromandibular dystonia, and cervical dystonia; (2) botulinum toxin is not curative in chronic neurological disorders; (3) the safety of botulinum toxin therapy during pregnancy, breast feeding, and chronic use during childhood is unknown; (4) the long-term effects of chronic treatment with botulinum toxin remain unknown; and (5) botulinum toxin should be administered by committed interdisciplinary teams of physicians and related health care professionals with appropriate instrumentation. The full text of the consensus panel's statement follows.
 ...
PMID:Botulinum toxin. 209 81

Diltiazem, a Ca-channel blocker that is used clinically for the treatment of hypertension and cardiac arrhythmias, reduces the contractility of extraocular muscles. Exposure of rabbit extraocular muscle to diltiazem in vitro reduces the sustained tension that is generated by the tonic, multiply innervated fibers, and decreases the baseline, or resting, tension of the muscle. When diltiazem is injected into a selected extraocular muscle in the rabbit in vivo, it causes a temporary weakening of the muscle, which is indicated by a deviation of eye position. These in vivo effects are of short duration, are easily reproducible, and vary with dosage. The results of this study raise the possibility that diltiazem may be used as an alternative to the surgical treatment of strabismus and other oculomotor dysfunctions including blepharospasm.
 ...
PMID:Diltiazem reduces the contractility of extraocular muscles in vitro and in vivo. 213 91

The paralytic properties of botulinum A toxin have led to its use in humans in the treatment of strabismus and facial dystonias such as essential blepharospasm. Examination of orbicularis muscle from 10 patients with essential blepharospasm who received 2-18 injections of botulinum toxin 6 weeks to 3 years prior to surgery revealed characteristic nodal, terminal and ultraterminal "sprouting" of the motor axons. Orbicularis muscle from five individuals never exposed to botulinum failed to demonstrate these changes. The significance of persistent motor nerve sprouting in response to botulinum exposure remains to be elucidated.
 ...
PMID:Motor nerve sprouting in human orbicularis muscle after botulinum A injection. 233 57

BTX injection has been used for 11 years by 292 ophthalmologists in 8,854 patients aged three months to 90 years in a variety of eye muscle and eyelid disorders. No systemic toxic reaction has occurred, local complications are few, and visual loss has not occurred in any case. In blepharospasm and hemifacial spasm BTX appears to fill an important need, since no other drug is reliably effective and since surgical interventions have substantial side effects. Strabismus cases with active uveitis, hypotony, previous detachment surgery, active thyroid eye disease, and recent paralytic strabismus are often poor candidates for surgical intervention. Some patients in each of these categories were treated effectively and safely by BTX injection. Surgery is clearly the preferred treatment modality in large angle deviations, in chronic paralytic strabismus, in cases where diplopia for a month or two from injection would incapacitate the patient, in nystagmus, in oblique muscle disorders and A-V patterns, where muscles have been misplaced and where restrictions to alignment have been created by disease or prior surgery. Side by side comparisons of surgery and injection in congenital esotropia and in concomitant strabismus of 50 PD or less should result in further clarification of treatment choices as to effectiveness, side effects and cost. BTX is presently available only to clinical investigators using the drug under research protocols.
 ...
PMID:Botulinum toxin therapy of eye muscle disorders. Safety and effectiveness. American Academy of Ophthalmology. 277 91


1 2 3 4 5 6 7 8 Next >>