Hemifacial Spasm

This research focuses on patients experiencing stiff knee gait (SKG), a condition caused by spastic muscle complications in the leg that can result from stroke, brain injury, spinal cord damage, or multiple sclerosis. SKG affects the mobility of the knee joint, leading to stiffness that hampers walking ability. The study aims to observe and compare balance and risk of falls before and after treatment with botulinum toxin injections in the rectus femoris muscle, which is a current standard treatment to reduce muscle spasticity in these patients. Participants will receive botulinum toxin injections targeted to the rectus femoris muscle. The study is observational and will evaluate the effects of these injections on balance and walking ability without altering standard care. Functional clinical tests such as the Time Up and Go test, Berg Balance Scale, Stair Climb and Descent Time test, and a questionnaire about the number of falls will be used to assess participants before and four weeks after the injections. Throughout the study, participants will undergo these clinical tests to measure static and dynamic balance and walking function. Researchers will specifically focus on the Time Up and Go test as the primary outcome four weeks after treatment. Secondary outcomes include balance scale scores, stair climbing times, and fall frequency. The study will also monitor safety and compliance. The total study duration for each participant is at least four weeks from the inclusion visit to the post-injection evaluation.

Meige syndrome is a rare and challenging movement disorder that causes involuntary muscle contractions affecting the eyes, jaw, and neck. It often does not respond well to medications. Researchers are studying the safety and effects of a new approach using deep brain stimulation (DBS) targeting two brain areas: the ventralis oralis (VO) nucleus and the subthalamic nucleus (STN) in patients with Meige syndrome to potentially improve symptoms. Participants will receive surgery to implant electrodes in both brain areas. After the device is turned on, one group will first receive stimulation only in the VO area, and the other group will receive stimulation only in the STN area. After three months, both groups will receive combined stimulation in both brain targets. This study is randomized and double-blind to compare the effects of these treatments. Participants will be evaluated for symptom improvement using the Burke-Fahn-Marsden Dystonia Rating Scale over one year after stimulation begins. Other assessments include quality of life, anxiety, depression, and cognitive tests. Researchers will monitor any side effects related to the DBS procedure. The study results aim to guide future treatment options for Meige syndrome.

Researchers are evaluating the effects of DaxibotulinumtoxinA-Lanm (Daxxify) in people with benign essential blepharospasm (BEB) and hemifacial spasms (HFS). This study aims to determine if there is a significant difference in symptom improvement compared to previous Botox treatment, using the Jankovic Rating Scale (JRS) to measure changes. Patients who have been treated with Botox will switch to Daxxify to serve as their own control in this single-arm crossover study. Participants will receive Daxxify injections using a 2:1 conversion ratio to Botox units. Those with BEB will receive Daxxify at 10 sites in the superficial dermis typical for BEB, while those with HFS will receive injections at 8 such sites. The dosing is scheduled to coincide with when they would normally get their next Botox treatment, with no washout period. Patients will be monitored monthly for up to nine months to track the duration and effectiveness of the treatment. During the study, researchers will assess therapeutic response based on changes in the modified Jankovic Rating Scale at various time points, including before treatment, and one, three, and monthly up to nine months after treatment. They will also document any side effects and discontinue treatment if adverse effects outweigh benefits. Additional evaluations include the waning of effect, loss of efficacy, and incidence of treatment failure. This ongoing monitoring ensures patient safety and comprehensive data collection throughout participation.

This research aims to explore the therapeutic effect of Botulinum toxin (Botox) injections in patients with trismus, a common side effect of radiation therapy for head and neck cancer. The study evaluates how Botox injections combined with oral rehabilitation exercises may help reduce muscle tension and spasms in the masticatory muscles, potentially improving mouth opening, quality of life, trismus condition, and pain. Participants will be randomly assigned to receive either echo-guided Botox injections or echo-guided normal saline injections into the masticatory muscles, including the medial pterygoid muscle. The study uses a triple-masked design to compare these treatments. The treatment period lasts up to six months, during which patients also perform oral rehabilitation exercises to support muscle function. During the trial, participants' maximal mouth opening will be measured from enrollment through the six-month treatment period. Researchers will also assess quality of life, trismus symptoms, and pain levels. The study monitors the patients' health conditions to ensure stability and safety throughout the treatment. Overall participation lasts at least six months, with close observation of treatment effects and any side effects.

Researchers are evaluating the use of oral cortisone (prednisolone) treatment in children aged 1 to 17 years who have acute peripheral unilateral facial nerve palsy. This condition affects about 10 to 20 children per 100,000 annually in Sweden, with 20% experiencing lasting symptoms such as excessive tearing, drooling, and facial asymmetry. The study is a double-blind, randomized, placebo-controlled multicenter trial aimed at assessing whether prednisolone improves recovery compared to placebo over 12 months. Participants will be randomly assigned to receive either prednisolone tablets dosed at 1 mg per kg of body weight daily for 10 days (up to a maximum of 50 mg per day) or placebo tablets that look identical. The treatment will start upon admission, and clinical data will be collected during follow-up visits. The primary outcome is full recovery of facial nerve function measured by the House-Brackmann scale at 12 months, with additional facial function and disability assessments also conducted. During the study, children will undergo clinical evaluations at regular intervals up to 12 months to monitor nerve recovery and facial function using several scales and questionnaires. Researchers will track adherence to treatment and monitor for any side effects or complications. The total participation time for each child will be approximately one year, allowing detailed observation of long-term outcomes and treatment effects.

This research aims to compare the effects of mandibular splint and Botox injection in the lateral pterygoid muscle on cervical muscle activity in patients with temporomandibular disorders (TMD). TMD involves pain and dysfunction in the jaw joint and muscles controlling jaw movement, often caused by internal displacement of the joint's disc. The study addresses common chronic musculoskeletal pain conditions affecting the orofacial area, focusing on how different treatments may influence muscle activity in this population. Participants are randomly assigned to one of three groups: Botox injection in the lateral pterygoid muscle combined with medications (muscle relaxants, antidepressants, and nonsteroidal anti-inflammatory drugs); mandibular stabilization splint combined with the same medications; or medication treatment alone. Botox is prepared at a concentration of 10 units per 0.1 mL and injected into the affected muscle, while the splint is worn as a dental device to realign the jaw. The study period includes treatment and follow-up to assess outcomes over three months. During the study, researchers measure muscle activity in the upper trapezius and sternocleidomastoid muscles three months after treatment. They evaluate amplitude and root mean square of muscle activity to assess treatment effects. Participants undergo regular monitoring, including assessments of symptoms and muscle function, with attention to safety and adherence. The total study duration extends from enrollment until three months post-treatment, with ongoing observation of cervical muscle activity changes.

Researchers are evaluating the safety and effectiveness of sphenopalatine ganglion block (SPGB) compared to intramuscular Botulinum Toxin Type A (BOTOX) injections in people with chronic migraine. Migraines are classified as primary headaches and involve complex nerve interactions. The study aims to compare these two treatments to better understand their effects on migraine pain. Participants are randomly assigned to one of two groups: one receiving 2 ml of 2% lidocaine administered via a nasal applicator in each nostril as the sphenopalatine block, and the other receiving 100 units of Botulinum Toxin Type A injected at fixed sites. Both treatments are given once, and the study does not use masking or blinding. During the 12 weeks after treatment, participants will have their pain levels assessed to measure treatment impact. Researchers will also track the percentage of patients free from headache and the rate of headache relief. The study involves regular monitoring of symptoms and treatment effects over this period to evaluate and compare both interventions.