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Sari ÜS, Eroglu M, Büyükşerbetçi G, Tokucoglu F, Sahin N. Positive effect of self-exercise following Botulinum toxin injection on the permanence of the recovery among the patients with HFS and BFS: A clinical trial. Medicine (Baltimore) 2024; 103:e38215. [PMID: 38875371 PMCID: PMC11175951 DOI: 10.1097/md.0000000000038215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/11/2024] [Accepted: 04/22/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Botulinum toxin (BoNT) injection serves as the primary modality for addressing hemifacial spasm (HFS) and blepharospasm (BFS), which are prevalent movement disorders affecting the craniofacial region. However, even though the short-term effectiveness of the botulinum injection may reach over 80%, the long-term effectiveness is still a debatable point Herein, we aim to investigate whether facial self-exercise following the BoNT injection can extend the time period of effectiveness. METHODS In this study, 51 volunteers who received Onabotilinumtoxin A (BoNTA) treatment for the diagnosis of HFS or BFS, were randomized into 2 groups. A detailed instruction about the self-exercise was given by an experienced physician to the subjects in Group 1. Volunteers were asked to repeat the exercise program afterward and continue to each movement for 5 seconds, to repeat each movement 10 times with a 10-second break, every day, 3 times a week for 1 week. hemifacial spasm grating scale (HSGS) and Jankovic scales were used to assess the efficacy of the treatment. RESULTS Both groups are similar to each other based on demographic features and the severity of the diseases. According to HSGS and Jankovic scales, at the end of the first month, there was no significant difference between the groups. At the end of the third month, the improvement achieved in the first month remained the same in each parameter in Group 1. On the other hand, in Group 2, most of the values returned to the baseline. CONCLUSION Facial self-exercise following the botulinum toxin application may extend the period of effectiveness of botulinum toxin treatment the subjects with HFS and BFS.
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Affiliation(s)
- Ümmü Serpil Sari
- Balikesir University Faculty of Medicine Neurology Department, Balikesir, Turkey
| | - Mehmet Eroglu
- Mersin Medical Park Hospital Physical Therapy and Rehabilitation Clinic, Mersin, Turkey
| | | | - Figen Tokucoglu
- Balikesir University Faculty of Medicine Neurology Department, Balikesir, Turkey
| | - Nilay Sahin
- Balikesir University Faculty of Medicine Physical Therapy and Rehabilitation Department, Balikesir, Turkey
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Gameiro GR, Yabumoto C, Osaki MH, Monteiro LG, Schor P, Osaki TH. Objective demonstration of eyelid spasm relief with smartphone and custom software in hemifacial spasm patients. Int Ophthalmol 2024; 44:144. [PMID: 38498055 DOI: 10.1007/s10792-024-03070-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/16/2024] [Indexed: 03/19/2024]
Abstract
PURPOSE To objectively demonstrate eyelid spasms relief in hemifacial spasm (HFS) patients using a smartphone and a custom-made software. METHODS Nineteen patients with HFS had standardized videos recorded with a smartphone (iPhone 6S, Apple) camera before and 15 days after receiving onabotulinumtoxinA injections. Nineteen age-matched control subjects were also assessed. The Eye Aspect Ratio (EAR) is an algorithm previously described to determine whether the eye is opened or closed. When the eye is closed, EAR tends to be closer to zero. Analogously, if the eye is wide open, values are greater. A custom-made software using the EAR concept was developed and pre- and post-treatment EARs were analyzed to assess HFS patients. RESULTS Botulinum toxin (BoNT) injections led to a significant increase in the average EAR of the affected side: + 10.4% (p = 0.0175) of HFS patients, compared to baseline. Mean EAR before BoNT applications were significantly lower (16.2%) on the affected side (0.25 ± 0.05) of HFS patients when compared to controls (0.30 ± 0.05, p = 0.004). After BoNT injections, no statistically significant difference was observed for the average EAR between the affected side of HFS patients (0.27 ± 0.04) and controls (p = 0.20). CONCLUSIONS Use of a smartphone and custom-made software objectively demonstrated eyelid spasm relief in patients with HFS. Additional refinement of this system could permit more accurate assessments of treatment response rates for each patient, making it possible to be used in clinical practice.
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Affiliation(s)
- Gustavo R Gameiro
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, R. Botucatu, 822, 04023-062, São Paulo, SP, Brazil
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Cristina Yabumoto
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, R. Botucatu, 822, 04023-062, São Paulo, SP, Brazil
| | - Midori H Osaki
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, R. Botucatu, 822, 04023-062, São Paulo, SP, Brazil
- Eye & Eyelid Experts, R. Joao Moura, 661, cj 84, 05412-001, São Paulo, SP, Brazil
| | - Lucas G Monteiro
- Department of Ophthalmology, University of Santo Amaro (UNISA), São Paulo, SP, Brazil
| | - Paulo Schor
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, R. Botucatu, 822, 04023-062, São Paulo, SP, Brazil
| | - Tammy H Osaki
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, R. Botucatu, 822, 04023-062, São Paulo, SP, Brazil.
- Eye & Eyelid Experts, R. Joao Moura, 661, cj 84, 05412-001, São Paulo, SP, Brazil.
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Lee HY, Park I, Luu MP, Zhao J, Vu JP, Cisneros E, Berman BD, Jinnah HA, Kim HJ, Liu CY, Perlmutter JS, Richardson SP, Weissbach A, Stebbins GT, Peterson DA. Interrater reliability of motor severity scales for hemifacial spasm. J Neural Transm (Vienna) 2023; 130:1269-1279. [PMID: 37466750 PMCID: PMC10480239 DOI: 10.1007/s00702-023-02667-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/24/2023] [Indexed: 07/20/2023]
Abstract
To compare the inter-rater reliability (IRR) of five clinical rating scales for video-based assessment of hemifacial spasm (HFS) motor severity. We evaluated the video recordings of 45 HFS participants recruited through the Dystonia Coalition. In Round 1, six clinicians with expertise in HFS assessed the participants' motor severity with five scales used to measure motor severity of HFS: the Jankovic rating scale (JRS), Hemifacial Spasm Grading Scale (HSGS), Samsung Medical Center (SMC) grading system for severity of HFS spasms (Lee's scale), clinical grading of spasm intensity (Chen's scale), and a modified version of the Abnormal Involuntary Movement Scale (Tunc's scale). In Round 2, clinicians rated the same cohort with simplified scale wording after consensus training. For each round, we evaluated the IRR using the intraclass correlation coefficient [ICC (2,1) single-rater, absolute-agreement, 2-way random model]. The scales exhibited IRR that ranged from "poor" to "moderate"; the mean ICCs were 0.41, 0.43, 0.47, 0.43, and 0.65 for the JRS, HSGS, Lee's, Chen's, and Tunc's scales, respectively, for Round 1. In Round 2, the corresponding IRRs increased to 0.63, 0.60, 0.59, 0.53, and 0.71. In both rounds, Tunc's scale exhibited the highest IRR. For clinical assessments of HFS motor severity based on video observations, we recommend using Tunc's scale because of its comparative reliability and because clinicians interpret the scale easily without modifications or the need for consensus training.
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Affiliation(s)
- Ha Yeon Lee
- Institute for Neural Computation, University of California, San Diego, La Jolla, CA, USA
| | - Ingyun Park
- Institute for Neural Computation, University of California, San Diego, La Jolla, CA, USA
| | - Minnie P Luu
- Institute for Neural Computation, University of California, San Diego, La Jolla, CA, USA
| | - Jerry Zhao
- Institute for Neural Computation, University of California, San Diego, La Jolla, CA, USA
| | - Jeanne P Vu
- Institute for Neural Computation, University of California, San Diego, La Jolla, CA, USA
| | - Elizabeth Cisneros
- Institute for Neural Computation, University of California, San Diego, La Jolla, CA, USA
| | - Brian D Berman
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA
| | - H A Jinnah
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Han-Joon Kim
- Department of Neurology and Movement Disorders Centre, Seoul National University Hospital, Seoul, South Korea
| | - Catherine Y Liu
- Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, USA
- Department of Ophthalmology, Rady Children's Hospital, San Diego, CA, USA
- Division of Oculofacial Plastic and Reconstructive Surgery, Shiley Eye Institute, University of California, San Diego, La Jolla, USA
| | - Joel S Perlmutter
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Departments of Radiology, Neuroscience, Physical Therapy, and Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Sarah Pirio Richardson
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- Neurology Service, New Mexico Veterans Affairs Health Care System, Albuquerque, NM, USA
| | - Anne Weissbach
- Institute of Systems Motor Science, University of Luebeck, Luebeck, Germany
- Institute of Neurogenetics, University of Luebeck, Luebeck, Germany
| | - Glenn T Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David A Peterson
- Institute for Neural Computation, University of California, San Diego, La Jolla, CA, USA.
- Computational Neurobiology Laboratory, Salk Institute for Biological Studies, 10010 N. Torrey Pines Rd, La Jolla, CA, 92037, USA.
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3D slicer-based calculation of hematoma irregularity index for predicting hematoma expansion in intracerebral hemorrhage. BMC Neurol 2022; 22:452. [PMID: 36471307 PMCID: PMC9720921 DOI: 10.1186/s12883-022-02983-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/18/2022] [Indexed: 12/08/2022] Open
Abstract
BACKGROUND Irregular hematoma is considered as a risk sign of hematoma expansion. The aim of this study was to quantify hematoma irregularity with computed tomography based on 3D Slicer. METHODS Patients with spontaneous intracerebral hemorrhage who underwent an initial and subsequent non-contrast computed tomography (CT) at a single medical center between January 2019 to January 2020 were retrospectively identified. The Digital Imaging and Communication in Medicine (DICOM) standard images were loaded into the 3D Slicer, and the surface area (S) and volume (V) of hematoma were calculated. The hematoma irregularity index (HII) was defined as [Formula: see text]. Logistic regression analyses and receiver operating characteristic (ROC) curve analysis were performed to assess predictive performance of HII. RESULTS The enrolled patients were divided into those with hematoma enlargement (n = 36) and those without the enlargement (n = 57). HII in hematoma expansion group was 130.4 (125.1-140.0), and the index in non-enlarged hematoma group was 118.6 (113.5-122.3). There was significant difference in HII between the two groups (P < 0.01). Multivariate logistic regression analysis revealed that the HII was significantly associated with hematoma expansion before (odds ratio = 1.203, 95% confidence interval [CI], 1.115-1.298; P < 0.001) and after adjustment for age, hematoma volume, Glasgow Coma Scale score (odds ratio = 1.196, 95% CI, 1.102-1.298, P < 0.001). The area under the ROC curve was 0.86 (CI, 0.78-0.93, P < 0.01), and the best cutoff of HII for predicting hematoma growth was 123.8. CONCLUSION As a quantitative indicator of irregular hematoma, HII can be calculated using the 3D Slicer. And the HII was independently correlated with hematoma expansion.
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Tambasco N, Filidei M, Nigro P, Parnetti L, Simoni S. Botulinum Toxin for the Treatment of Hemifacial Spasm: An Update on Clinical Studies. Toxins (Basel) 2021; 13:toxins13120881. [PMID: 34941718 PMCID: PMC8706367 DOI: 10.3390/toxins13120881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
Hemifacial spasm (HFS) is a movement disorder characterized by involuntary contractions of the facial muscles innervated by the seventh cranial nerve. Generally, it is associated with a poor quality of life due to social embarrassment and can lead to functional blindness. Moreover, it is a chronic condition, and spontaneous recovery is rare. Intramuscular injections of Botulinum Toxin (BoNT) are routinely used as HFS treatment. METHODS We reviewed published articles between 1991 and 2021 regarding the effectiveness and safety of BoNT in HFS as well as any reported differences among BoNT formulations. RESULTS The efficacy of BoNT for HFS treatment ranged from 73% to 98.4%. The mean duration of the effect was around 12 weeks. Effectiveness did not decrease over time. Adverse effects were usually mild and transient. The efficacy and tolerability of the different preparations appeared to be similar. Among the studies, dosage, injected muscles, intervals of treatment, and rating scales were variable, thus leading to challenges in comparing the results. CONCLUSIONS BoNT was the treatment of choice for HFS due to its efficacy and safety profile. Further studies are needed to investigate the factors that influence the outcome, including the optimal timing of treatment, injection techniques, dosage, and the best selection criteria for formulations.
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Affiliation(s)
- Nicola Tambasco
- Movement Disorders Center, Neurology Department, Perugia General Hospital and University of Perugia, 06129 Perugia, Italy;
- Neurology Department, Perugia General Hospital and University of Perugia, 06129 Perugia, Italy; (M.F.); (L.P.); (S.S.)
- Correspondence:
| | - Marta Filidei
- Neurology Department, Perugia General Hospital and University of Perugia, 06129 Perugia, Italy; (M.F.); (L.P.); (S.S.)
| | - Pasquale Nigro
- Movement Disorders Center, Neurology Department, Perugia General Hospital and University of Perugia, 06129 Perugia, Italy;
| | - Lucilla Parnetti
- Neurology Department, Perugia General Hospital and University of Perugia, 06129 Perugia, Italy; (M.F.); (L.P.); (S.S.)
| | - Simone Simoni
- Neurology Department, Perugia General Hospital and University of Perugia, 06129 Perugia, Italy; (M.F.); (L.P.); (S.S.)
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Wabbels B, Yaqubi A. Validation of a new hemifacial spasm grading questionnaire (HFS score) assessing clinical and quality of life parameters. J Neural Transm (Vienna) 2021; 128:793-802. [PMID: 33963897 PMCID: PMC8205881 DOI: 10.1007/s00702-021-02343-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/20/2021] [Indexed: 11/08/2022]
Abstract
Validation of the new hemifacial spasm (HFS) questionnaire “HFS score” that captures both clinical (HFS clinical) and health-related quality of life (HRQOL) parameters (HFS subjective) in one tool and comparison with a global HRQOL questionnaire. Cross sectional, prospective validation study including 143 subjects (62 HFS patients and 81 healthy volunteers) from the University Eye Hospital Bonn. Patients were interviewed with the new HFS score and the SF-12 questionnaire prior to and 3 weeks after Botulinum neurotoxin A (BoNT-A) injection. All HRQOL-related questions (HFS subjective) were answered on a visual analogue scale (VAS) ranging from 0 (no complaints) to 100% (maximum complaints) by the patients themselves. Reproducibility was tested in a study extension with 10 patients by repeat interviews (telephone/personal). The new HFS score questionnaire provided a reliable clinical assessment and demonstrated that BoNT-A therapy significantly reduced frequency and severity of eye and cheek spasms (p < 0.001; Wilcoxon test). Relevant aspects of HRQOL of HFS patients were assessed with high accuracy and sensitivity. Significant improvements were achieved after BoNT-A injection in five out of eight HRQOL parameters (p ≤ 0.02; Wilcoxon test). Cronbach’s alpha of 0.818 demonstrated good internal consistency. Telephone survey provided comparable results to personal interviews. This new sensitive and specific HFS score seems a reliable instrument to monitor BoNT therapy and customize it to the needs of the individual HFS patient—in clinical studies and daily clinical practice.
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Affiliation(s)
- Bettina Wabbels
- Department of Ophthalmology, University of Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany.
| | - Ali Yaqubi
- Department of Ophthalmology, University of Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Germany.,Ophthalmological Center Lippstadt, Wiedenbrücker Str. 31, 59555, Lippstadt, Germany
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Park CK, Lim SH, Lee SH, Park BJ. Is the pre-operative lateral spread response on facial electromyography a valid diagnostic tool for hemifacial spasm? Neurosurg Rev 2021; 44:3259-3266. [PMID: 33559796 DOI: 10.1007/s10143-020-01267-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/28/2020] [Accepted: 02/10/2020] [Indexed: 11/30/2022]
Abstract
The lateral spread response (LSR) on preoperative facial electromyogram (EMG) is a useful tool in evaluating patients with hemifacial spasm (HFS). There may be some instances where the LSR does not appear on the preoperative EMG, thus disrupting the diagnosis and treatment of HFS. In this study, we evaluated the patients who did not exhibit LSR on preoperative EMG but underwent microvascular decompression (MVD) for hemifacial spasm. We searched for patients who underwent MVD for HFS but had an absence of LSR on preoperative EMG between January 2016 and June 2018. Surgical outcomes were evaluated at 1, 3, and 6 months after surgery. Follow-up facial EMG was performed 3 months after surgery. Results were divided into two categories: (1) spasm relief within 24 h of surgery and (2) spasm was observed immediately post-operation. The following parameters were analyzed when comparing between the two groups: age, sex, affected side, duration of symptoms, and offending vessel(s). A total of 306 patients underwent MVD for HFS during the study period. Among them, 13 (4.2%) patients had no LSR on preoperative EMG. Eight patients (61.5%) were female and five patients were male. The 13 patients had a mean age of 51 years. All patients exhibited probable offending vessels in the root exit zone (REZ) of the facial nerve on preoperative magnetic resonance (MR) imaging that was confirmed during surgery. Seven patients were free of HFS immediately after surgery, though six patients were not. Only one (7.7%) patient had persisted symptom 6 months after surgery. No patients experienced recurrence of spasm, nor exhibited abnormal waves on follow-up facial EMG. LSR on facial EMG is a valuable tool for evaluating hemifacial spasm. However, although LSR did not appear on preoperative EMG, if the patient presents with typical symptoms and the offending vessels are identified on MRI, we expect good results after MVD for HFS.
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Affiliation(s)
- Chang Kyu Park
- Department of Neurosurgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, South Korea
| | - Seung Hoon Lim
- Department of Neurosurgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, South Korea
| | - Seung Hwan Lee
- Department of Neurosurgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, South Korea
| | - Bong Jin Park
- Department of Neurosurgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, South Korea.
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Clinical RoPE (cRoPE) score predicts patent foramen ovale detection among stroke patients: a multicenter observational study. Neurol Sci 2020; 41:3227-3233. [PMID: 32388644 DOI: 10.1007/s10072-020-04386-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/28/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUD The role of patent foramen ovale (PFO) in cryptogenic stroke (CS) is debated. Tools to predict PFO occurrence and attributable fraction are needed to guide cost-effective diagnostics and treatment. Risk of Paradoxical Embolism (RoPE) score relies on neuroimaging findings, which might be inconclusive in up to 30% of cases. METHODS We developed a clinical-based easy tool to predict the presence and attributable fraction of PFO in CS patients, without using neuroimaging. The clinical RoPE (cRoPE) score, ranging 1-10, was elaborated through Delphi method from the original RoPE score, replacing cortical infarction with the Oxfordshire Community Stroke Project (OCSP) classification (lacunar stroke = 0 points, other subtypes = 1 point). Then, from the SISIFO (Studio Italiano di prevalenza nello Stroke Ischemico di pervietà del Forame Ovale, or Prevalence of Patent Foramen Ovale in Ischemic Stroke in Italy) study, a multicenter, prospective study on consecutive acute ischemic stroke patients (n = 1130) classified by Trial of Org 10172 in Acute Stroke Treatment (TOAST) and OCSP criteria and undergoing PFO testing, we selected the VV-CDC cohort (Vibo Valentia, Città di Castello, n = 323) to test the accuracy of cRoPE in predicting PFO detection. We compared cRoPE with RoPE to verify cRoPE reliability. Finally, we tested, through ROC analysis, the performance of cRoPE depending on TOAST classification. RESULTS Overall, PFO was detected in 21% in VV-CDC and in 23.4% in remaining SISIFO cohort (n = 807). cRoPEAUC and RoPEAUC were similar in VV-CDC. cRoPE performance was comparable with RoPE among CS (cRoPEAUC 0.76, 95%CI 0.67-0.85, RoPEAUC 0.75, 95%CI 0.66-0.84). Moving to the remaining SISIFO cohort, cRoPE confirmed satisfactory accuracy in predicting PFO detection in CS patients (cRoPEAUC 0.71, 95%CI 0.66-0.78, p = 0.032). CONCLUSIONS Conclusions: cRoPE might help in stratification of patients with CS, allowing accurate esteem of the likelihood of PFO to be found, especially in cases when neuroimaging is inconclusive.
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Osaki TH, Osaki MH, Garcia DM, Osaki T, Ohkawara L, Belfort R, Cruz AAV. Evaluation of botulinum toxin effects in hemifacial spasm patients: correlation between clinical rating scales and high-speed video system measurements. J Neural Transm (Vienna) 2020; 127:1041-1046. [PMID: 32232566 DOI: 10.1007/s00702-020-02183-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to compare the scores of two clinical rating scales and high-speed video system measurements obtained during spontaneous eyelid movements in hemifacial spasm (HFS) patients before and after treatment. Patients were evaluated before and 30 days after receiving treatment with onabotulinumtoxinA injections. Using a high-speed video system, the eyelid movements were recorded bilaterally for 3 min and the energy power generated by the upper eyelid during spontaneous eyelid movements was assessed before and after treatment. The scores of the Jankovic rating scale (JRS) and Hemifacial Spasm Grading System (HSGS) were also assessed before and after treatment. The authors studied 22 patients. Significant reduction in JRS and HSGS scores and in the energy generated by the upper eyelid was observed after treatment. A power spectrum of less than 23,000 was associated with JRS and HSGS scores less than 4 and 6.25, respectively and a power spectrum greater than or equal to 23,000 was associated with JRS and HSGS scores greater than or equal to 4 and 6.25, respectively (p < 0.0001 and p = 0.0025). Rating systems are easy to use, but they may exhibit limitations in sensitivity to assess differences between distinct disease patterns and between subtle differences in treatment responses. The high-speed video system permits a greater degree of accuracy, which allows for the assessment of differences in eyelid movement patterns and would permit better tailoring of treatment to patients. However, simpler devices employing this system would need to be developed, so that it could be used in clinical practice.
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Affiliation(s)
- Tammy H Osaki
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo-EPM/UNIFESP, São Paulo, SP, Brazil
- Department of Ophthalmology, University of Santo Amaro, São Paulo, SP, Brazil
- Osaki Clinics, R. Vergueiro, 2045 cj. 1009, São Paulo, SP, 04101-000, Brazil
| | - Midori H Osaki
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo-EPM/UNIFESP, São Paulo, SP, Brazil.
- Osaki Clinics, R. Vergueiro, 2045 cj. 1009, São Paulo, SP, 04101-000, Brazil.
| | - Denny M Garcia
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of S. Paulo/Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Teissy Osaki
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo-EPM/UNIFESP, São Paulo, SP, Brazil
- Osaki Clinics, R. Vergueiro, 2045 cj. 1009, São Paulo, SP, 04101-000, Brazil
| | - Lilian Ohkawara
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo-EPM/UNIFESP, São Paulo, SP, Brazil
| | - Rubens Belfort
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo-EPM/UNIFESP, São Paulo, SP, Brazil
| | - Antonio Augusto V Cruz
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of S. Paulo/Ribeirão Preto, Ribeirão Preto, SP, Brazil
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