Frequency and characterization of facial pain in individuals with hemifacial spasm in an outpatient clinic of a public tertiary center
Notice bibliographique
Résumé
Background: Hemifacial spasm (HFS) is a movement disorder marked by involuntary facial muscle contractions, often due to a nearby blood vessel pressing on the facial nerve. Typically, HFS onset occurs between the fourth and sixth decades of life and has an annual incidence of 0.78 per 100,000, being considered a rare disorder. Botulinum toxin type A (BoNT-A) stands as the gold-standard therapy in the treatment of HFS. The presence of facial pain associated with HFS is commonly observed in clinical practice, although there is still little research on the subject. Objective: To characterize facial pain patterns in patients with HFS by evaluating the location, frequency, intensity, and duration of pain, as well as its relation to BoNT-A injections. Methods: A cross-sectional study was conducted with 53 HFS patients (F: 35, M: 18) at a public tertiary hospital over 6 months. The average age was 66.1 years (SD 12.2). Patients with cognitive impairment, BoNT-A use in the last three months, and other movement disorders were excluded. Data were collected using sociodemographic and structured facial pain questionnaires, the McGill Pain Questionnaire, and the HFS-Score for quality of life. Statistical analyses were performed using Epi Info software. Results: Among the 53 patients, 23 (43%) reported facial pain. The most common location was the periorbital region in 17 cases (65%), followed by maxillary region in 4 patients (15.3%), mandibular in 2 patients (7.6%), and auricular, whole hemiface and bilateral palpebra in 1 case (3.8%) each. All patients described pain ipsilaterally to the spasm side, and 1 patient described pain involving palpebral areas bilaterally. Spasms were present on the left side of the face in 33 (62%) patients. The average pain intensity was 6.1 on the Visual Analog Scale (VAS) (SD 2.1), with a mean frequency of 8.6 (SD 7.7) days/month and 2.3 (SD 2.3) episodes/day, lasting an average of 9.6 hours (SD 10). The average time to pain onset after HFS motor symptoms was 9.9 years (SD 9). Twenty patients reported that previous BoNT-A applications improved facial pain, while the remaining three reported no change. No patient reported a perception of worsening pain after BoNT-A injections. Although facial pain was frequently reported by the patients, no statistically significant difference was found between the severity of facial pain and the quality of life among individuals with HFS (p value 0,1993). The most common descriptors for the facial pain were: pulling (11 patients), itchy (10 patients), annoying (10 patients), miserable (9 patients), pinching (9 patients) Conclusion: This study highlights the need to investigate and treat facial pain in patients with hemifacial spasm, a rare and debilitating condition. Analyzing pain patterns and the efficacy of botulinum toxin treatment underscores the importance of tailored therapeutic approaches and guides future research.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».