RESUMEN
BACKGROUND: Severe generalized spastic movement disorders of various aetiologies often involve the jaw muscles and lead to a spastic trismus with masseter muscle hypertonia. We report a placebo-controlled randomized study on patients with spastic trismus. METHODS: Eleven patients with masseter hypertonia because of stroke, hypoxic encephalopathy or traumatic brain injury were allocated to either botulinum toxin serotype B (BoNT/B) injections into the masseter muscles or placebo treatment. The dental gap, the amount of saliva, salivation scales, and a clinical goal attainment were evaluated. RESULTS: Three weeks after injection the BoNT/B group showed a significantly increased mouth opening compared with placebo treatment (P < 0.05). In addition to the muscle paralysing effect, a goal attainment scale demonstrated a clinical benefit for the BoNT/B group (P < 0.01). CONCLUSIONS: Botulinum toxin serotype B injections into the masseter muscles effectively reduce hypertonia and provide for better mouth opening, thereby contributing to a positive and desired clinical goal.
Asunto(s)
Toxinas Botulínicas/uso terapéutico , Trismo/tratamiento farmacológico , Adulto , Anciano de 80 o más Años , Toxinas Botulínicas Tipo A , Método Doble Ciego , Humanos , Músculo Masetero/efectos de los fármacos , Persona de Mediana Edad , Espasticidad Muscular/tratamiento farmacológicoRESUMEN
A slide projection test was applied to investigate the ability of children to recognize faces and vases. Boys and girls between age 7 and 16 years were investigated. During the inspection series the subjects had to judge 42 black and white photographs of 14 male faces, 14 female faces and 14 vases. One hour after the inspection series a two-choice recognition test (6-s presentation) was performed and 1 week later the second recognition test. (1) During the inspection series the subjects had to make 42 forced-choice decisions as to whether they liked or disliked the projected face or vase. The number of positive responses for vases was in all age groups significantly higher than for faces. For both items positive response scores decreased with age. (2) In all age groups recognition and recall after 1 h was better for faces than for vases. For both items the 7- and 8-year-old children had a significantly higher error score than the other age groups. Boys reached adult performance levels at 9-10 years of age. Under age 15 to 16 years, male subjects had a significantly better face recognition ability than female subjects. This is in contrast to the repeatedly found adult female superiority in face recognition. The sex of the faces and the emotional responses during the inspection series were found to have a slight influence on face recognition. (3) Correct item recognition decreased after 1 week for those items (faces and vases) seen in the inspection series only and not in the first test after 1 h.(ABSTRACT TRUNCATED AT 250 WORDS)