Abstract
Purpose: To report the unexpectedly prolonged effect of botulinum toxin A (BTX) injection in patients with myasthenia gravis. Methods: Retrospective review of presenting history, clinical findings and treatment of two cases. Results: Two patients with myasthenia gravis underwent a single BTX injections for gustatory epiphora (case 1) and hemifacial spasm (case 2). The effect of the treatment lasted 18 months and at least 8 months respectively. Conclusion: We report the prolonged effect of BTX in two patients with myasthenia gravis. To our knowledge, the prolonged and distant effect of BTX in myasthenia gravis has not been specifically addressed in the literature. We postulate that this prolonged effect may be due to the presence of autoantibodies in patients with myasthenia gravis.
Highlights
Botulinum toxin A (BTX) injection is a recognised treatment for facial dystonias including blepharospasm, hemifacial spasm, aberrant facial nerve regeneration (AFR), strabismus and for therapeutic ptosis [1,2] Its effect usually lasts 3 to 4 months
A 63 year old woman was referred complaining of gustatory epiphora that had developed alongside AFR following a right lower motor neurone seventh nerve palsy due to a closed head injury 10 years previously
We report the prolonged effect of botulinum toxin A (BTX) in two patients with myasthenia gravis (MG)
Summary
Botulinum toxin A (BTX) injection is a recognised treatment for facial dystonias including blepharospasm, hemifacial spasm, aberrant facial nerve regeneration (AFR), strabismus and for therapeutic ptosis [1,2] Its effect usually lasts 3 to 4 months. Anti-acetylcholine receptor (anti-AchR) antibodies were negative but single-nerve fibre electromyography (SFEMG) of facial muscles was positive at that time. The patient underwent a routine BTX injection (7.5units, Botox®) to the orbital lobe of the right lacrimal gland through a transcutaneous approach. The effect of the botulinum toxin injection persisted for 18 months following treatment before her gustatory epiphora returned.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of Clinical & Experimental Ophthalmology
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
