Introduction: Botulinum toxin (BoNT) is a protein secreted by the anaerobic Gram-negative bacterium Clostridium botulinum. Among the seven known subtypes, type A is the most commonly used in women to treat diseases. It primarily blocks presynaptic release of acetylcholine at the neuromuscular junction, resulting in temporary muscle paralysis; thus, it is suitable for treating dystonia and other systemic diseases. BoNT is used widely for treating diseases that persist throughout, and may worsen during, pregnancy, such as cervical dystonia and achalasia. Thus, it is important to investigate whether BoNT injection during pregnancy causes side effects in pregnant women, fetuses, or newborns. Areas covered: This review highlights the efficiency and safety of BoNT injection in pregnancy. and assessed current literature with respect to the use of BoNT for disease treatment during pregnancy. Expert opinion: BoNT injection does not increase the risk of complications in pregnant women and fetuses. However, the use of BoNT to treat disease during pregnancy requires fully informed consent from patients. In addition, further research is needed to determine how to reduce the side effects of BoNT injection during pregnancy (e.g., by improving drug composition, or adjusting the amount of BoNT or the injection interval).

To determine the effects of botulinum toxin type A (BoNT-A) injections on self-esteem and quality of life (QOL) in blepharospasm patients, we enrolled 87 patients into the study. Patients completed the WHOQOL-BREF questionnaire, the Self-Esteem Scale (SES), and the Ocular Surface Disease Index (OSDI) before treatment on the date of enrollment and again after 4 weeks of treatment with BoNT-A. The overall QOL, general health status, the physiological and psychological domain scores of the WHOQOL-BREF, and the SES score significantly improved after treatment. The motor symptoms improved, and the OSDI score increased after treatment. Overall QOL and SES scores were correlated with disease duration, while psychological domain scores were correlated with mean duration of therapeutic effect. All variables correlated with OSDI scores. In conclusion, BoNT-A injections improved QOL and self-esteem in blepharospasm patients.

Bradykinin (BK) is a major kinin substance in the Kallikrein-Kinin System (KKS) that acts in conjunction with target cell bradykinin receptors and is involved in a variety of systems and organs. Functional regulation and pathophysiological processes such as cardiovascular, renal, central nervous system regulation, glucose metabolism, cell proliferation, smooth muscle contraction, inflammation, pain, shock, and tissue damage processes, etc. The role and mechanism of receptors in the mediation of ischemic injury in tissues was reviewed.

Objective: To determine whether serum levels of anti-acetylcholine receptor antibody (anti-AChR-Abs) are related to clinical parameters of blepharospasm (BSP). Methods: Eighty-three adults with BSP, 60 outpatients with hemifacial spasm (HFS) and 58 controls were recruited. Personal history, demographic factors, response to botulinum toxin type A (BoNT-A) and other neurological conditions were recorded. Anti-AChR-Abs levels were quantified using an enzyme-linked immunosorbent assay. Results: The anti-AChR Abs levels were 0.237 ± 0.022 optical density units in the BSP group, which was significantly different from the HFS group (0.160 ± 0.064) and control group (0.126 ± 0.038). The anti-AChR Abs level was correlated with age and the duration of response to the BoNT-A injection. Conclusion: Patients with BSP had an elevated anti-AChR Abs titer, which suggests that dysimmunity plays a role in the onset of BSP. An increased anti-AChR Abs titer may be a predictor for poor response to BoNT-A in BSP.

Background: The trigeminal neuralgia (TN) is characterized by a unilateral, episodic, electric shock-like pain in the distribution of the trigeminal nerve. Both drug therapy and radiofrequency thermocoagulation (RT) are used to treat TN. Objective: To compare the efficacy and safety of RT and drug therapy in patients with TN. Methods: Between October 2020 and December 2022, 62 patients with TN were allocated to undergo TN treatment (group A) or drug therapy (group B). In group A, 30 patients received RT treatment, whereas 32 patients in group B receive drug treatment. Pain relief, clinical outcomes, and adverse events in both groups were evaluated. Results: And significantly greater reduction in Visual Analogue Scale scores was noted in group A than in group B in the initial 2-week period (P < .05). The excellent rate was 93.3% (28/30) in group A, whereas it was 68.8% (22/32) in group B during the initial 2-week period (P < .05). A total of 62 patients were followed up at least 12 months, with a mean follow-up time of 14.5 months. But there were no statistically significant differences between the 2 groups at the final follow-up. A total of 24 patients had facial numbness in group A. In contrast, ten patients in group B complained of discomfort including sedation, dizziness, nausea, vomiting. During the follow-up period, 4 patients in group A and 6 patients in group B experienced recurrent pain. Conclusion: RT is a safety and effective treatment for patients with classic TN, providing more benefits of quicker pain relief and higher patient’s satisfaction, compared with traditional drug therapy.