How is Meige syndrome treated?

  There are three main treatment options for Meige syndrome: oral medications, local injections of botulinum toxin type A and surgery. It has been documented that there is a great deal of individual variability in the efficacy of oral medications. Dopamine receptor blockers such as haloperidol, anticholinergic agents such as Antanomics and γ-aminobutyric acid enhancers such as clonazepam may reduce clinical symptoms in patients. These drugs may be used alone or in combination. In the present case, the treatment with haloperidol combined with Antan was more effective, but rebound occurred after discontinuation, which is consistent with most of the previous reports in the literature. In the past decade, local injection of botulinum toxin type A, a neurotoxin produced by Clostridium perfringens, has been used to treat Meige’s syndrome with satisfactory results at home and abroad, and is injected locally into the spastic muscle to inhibit the release of acetylcholine from the presynaptic membrane and prevent nerve impulses from reaching the muscle, thus relieving muscle spasm. Retrospective studies have shown that the overall efficiency of local injection of botulinum toxin type A in the treatment of Meige syndrome is about 90%, and there are few adverse effects, but some patients need repeated injections, which may cause the organism to be resistant to the drug and result in reduced efficacy. It has been shown that deep brain stimulation (DBS) is an emerging method for the successful treatment of Meige syndrome, in which microelectrodes are implanted in the nucleus accumbens or pallidum for continuous electrical stimulation to regulate muscle tone. Several clinical investigations have shown that DBS has good efficacy and is a possible treatment for Meige syndrome, but there is a lack of controlled double-blind trials with large samples, so further studies are needed.