Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr;82(4):1-7.
doi: 10.1055/s-0044-1785691. Epub 2024 Apr 19.

Effects of onabotulinum toxin type A injections in patients with Meige's syndrome

Alexia Duarte  1 , Léo Coutinho  2 , Francisco Manoel Branco Germiniani  3 , Hélio Afonso Ghizoni Teive  1   3
Affiliations

Effects of onabotulinum toxin type A injections in patients with Meige's syndrome

Alexia Duarte et al. Arq Neuropsiquiatr. 2024 Apr.

Abstract
in English, Portuguese

Background: Meige's syndrome is a type of facial dystonia characterized by the simultaneous occurrence of blepharospasm and oromandibular dystonia. Although botulinum toxin type A (OBTA) injections are the standard treatment, evidence of their effectiveness and safety in this scenario is still lacking.

Objective: Our research aimed to evaluate the improvement and occurrence of side effects following injections of onabotulinum toxin type A (OBTA) in patients with Meige's syndrome.

Methods: Patients with Meige's syndrome undergoing botulinum toxin injections were enrolled in this study. We assessed dystonia intensity before and 14 days after OBTA injection using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) to measure the response of symptoms in the eyes (blepharospasm) and mouth (oromandibular dystonia). Other variables, such as dosage, side effects, and demographic data, were also recorded.

Results: The study included 41 participants, with a mean age of 67.7 years and a female-to-male ratio of 3.5:1. The mean BFMDRS score before the injections was 8.89, and after 14 days, it was 2.88. The most reported side effect was ptosis, with a 7.3% incidence. OBTA significantly reduced dystonia severity (p < 0.0001). The clinical response for the blepharospasm component was superior to the oromandibular dystonia component.

Conclusion: Our results support that OBTA seems to be an effective and safe therapeutic option for treating Meige's syndrome. The effect of OBTA was more pronounced in the treatment of blepharospasm than in oromandibular dystonia.

Antecedentes: A síndrome de Meige (SM) é caracterizada pela ocorrência concomitante de blefarospasmo e distonia oromandibular. Embora a toxina onabotulínica do tipo A (TBA) seja o tratamento de escolha, há uma falta de evidências sobre sua eficácia e segurança nesse cenário.

Objetivo: O objetivo do nosso estudo foi avaliar os efeitos obtidos com a aplicação de TBA em pacientes com SM. MéTODOS: Pacientes com SM que realizam aplicação de TBA foram convidados a participar desse estudo. Os participantes foram questionados sobre a intensidade da distonia antes e 14 dias após a injeção de TBA, utilizando a Escala de Distonia de Burke-Fahn-Marsden (EDBFM) para mensurar a resposta obtida em cada segmento. Outras variáveis, como dose, ocorrência de efeitos colaterais e dados demográficos, também foram registradas.

Resultados: O estudo contou com 41 participantes (idade média de 67,7; razão de 3,5 pacientes do sexo feminino para cada participante do sexo masculino). O escore médio na EDBFM antes das aplicações de TBA era 8,89, e, após 14 dias, 2,88. O efeito colateral mais reportado foi ptose (7.3%). A TBA foi capaz de reduzir a severidade da distonia (p < 0.0001), principalmente do blefarospasmo. CONCLUSãO: Nossos resultados corroboram que a TBA é uma terapêutica eficaz e segura no tratamento da SM. O efeito da TBA é superior no manejo do blefarospasmo em relação à distonia oromandibular.

PubMed Disclaimer

Conflict of interest statement

There is no conflict of interest to declare.

Figures

Figure 1
Figure 1
Infographic summarizing the flowchart for this study.
Figure 2
Figure 2
Injection sites and dosage. A : facial muscles; image used under license from Kenhub GmBH; illustrator: Yousun Koh; edited by the authors. B : pterygoid muscles; image used under license from Kenhub GmBH; illustrator: Yousun Koh; edited by the authors.
Figure 3
Figure 3
Boxplot graphics illustrating clinical response of dystonia as measured by the BFMDRS. Panels A-C correspond to the eye scores, panels D-F correspond to the mouth scores, and panels G-I correspond to the total scores.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Albanese A, Bhatia K, Bressman S B et al.Phenomenology and classification of dystonia: a consensus update. Mov Disord. 2013;28(07):863–873. doi: 10.1002/mds.25475. - DOI - PMC - PubMed
    1. Pandey S, Sharma S. Meige's syndrome: History, epidemiology, clinical features, pathogenesis and treatment. J Neurol Sci. 2017;372:162–170. doi: 10.1016/j.jns.2016.11.053. - DOI - PubMed
    1. LeDoux M S. Meige syndrome: what's in a name? Parkinsonism Relat Disord. 2009;15(07):483–489. doi: 10.1016/j.parkreldis.2009.04.006. - DOI - PMC - PubMed
    1. Ma H, Qu J, Ye L, Shu Y, Qu Q. Blepharospasm, Oromandibular Dystonia, and Meige Syndrome: Clinical and Genetic Update. Front Neurol. 2021;12:630221. doi: 10.3389/fneur.2021.630221. - DOI - PMC - PubMed
    1. Liu J, Li L, Li Y, Wang Q, Liu R, Ding H. Regional metabolic and network changes in Meige syndrome. Sci Rep. 2021;11(01):15753. doi: 10.1038/s41598-021-95333-8. - DOI - PMC - PubMed

Substances