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肉毒毒素治疗16例咀嚼肌痉挛   总被引:1,自引:0,他引:1  
目的探讨A型肉毒毒素治疗咀嚼肌痉挛患者的疗效。方法16例咀嚼肌痉挛患者,男女患者各8例,年龄21~87岁,平均61.7岁,其中表现为单纯咬颌型(Ⅰ型)的咀嚼肌痉挛12例,下颌错动型(Ⅱ型)4例,所有患者临床表现均为发作性咬牙、张口困难,神经系统无其他阳性体征,头颅CT或MRI无异常发现。咬颌型主要累及咬肌和颞肌,而错动型同时累及翼肌。应用A型肉毒毒素对患侧咀嚼肌采用多点注射方法,观察其治疗效果和副作用。结果13例症状得到显著改善(4例单侧咬颌型,8例双侧咬颌型中7例,4例下颌错动型中2例),3~10d起效,疗效持续时间8~26周,4例注射后出现患侧咬肌轻度麻痹,数周内恢复,未见其他副作用。症状复发者再次注射仍然有效。结论咀嚼肌痉挛患者局部注射A型肉毒毒素,确为一种有效、安全、简便易行的治疗手段,能在一段时间内缓解甚至消除肌肉痉挛及相关症状。  相似文献
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We describe a case of continuous motor unit potential (MUP) activity of central origin (unlike stiff man syndrome and progressive encephalomyelitis) characterized clinically by rigidity, painful muscle spasms, abnormal postures and spinal myoclonus. The topography of the manifestations, the subacute and benign course, the presence of stable sequels 2 years after onset and a searching process of differential diagnosis lead us to attribute the condition to an inflammation of the cord, which makes the case of particular clinical interest.
Sommario Descriviamo un caso con attività continua di potenziali di unità motoria (MUP) di origine centrale (diverso dalla sindrome dell'uomo rigido e della encefalomieliti progressive) clinicamente espresse da rigidità, spasmi muscolari dolorosi, posture abnormi e mioclono spinale. La topografia delle manifestazioni, il decorso subacuto e benigno, la presenza di esiti stabilizzati a distanza di due anni e un'attenta disamina differenziale, ci fanno ritenere l'affezione secondaria a un fatto infiammatorio midollare, il che rende il caso di particolare interesse clinico.
  相似文献
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目的 建立面肌痉挛 (HFS)动物模型 ,探讨异常肌反应 (AMR)与F波之间的相关性。方法  10只新西兰大白兔采用出茎乳孔段面神经主干脱髓鞘和血管压迫的方法复制HFS动物模型。术后第 6周 ,刺激面神经下颌缘支 ,分别在同侧眼轮匝肌和颏肌上检测AMR及F波 ,比较AMR/M、F/M波幅比率和AMR、F波持续时间之间的关系。结果 AMR/M和F/M波幅比率之间具有明显的相关性 (r=0 .86 0 2 ,P <0 .0 1) ;AMR和F波持续时间之间也呈明显的相关性 (r =0 .770 2 ,P <0 .0 1)。结论 F波与AMR有同源性 ;F波为HFS的术前诊断、术中监测和术后随访提供了更为直接的电生理指标  相似文献
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Microneurography was performed in a 39-year-old woman with demyelination of the pontine white matter associated with muscle spasms in the lower extremities. Single bursts on the microneurogram were observed immediately after cessation of the spasm with no systemic changes in the blood pressure or heart rate. Voluntary tonic flexion of the lower extremities induced similar bursts with small amplitudes. These reflex bursts possessed a characteristic of muscle sympathetic nerve activity, because the latency between the peak of each burst and the prior R-wave on the electrocardiograph was constant. The occurrence of these bursts suggests that a segmental compensatory mechanism in the spinal cord may stabilize the muscle blood flow influenced by muscle contraction.  相似文献
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Clonus can disrupt daily activities after spinal cord injury. Here an algorithm was developed to automatically detect contractions during clonus in 24 h electromyographic (EMG) records. Filters were created by non-linearly scaling a Mother (Morlet) wavelet to envelope the EMG using different frequency bands. The envelope for the intermediate band followed the EMG best (74.8-193.9 Hz). Threshold and time constraints were used to reduce the envelope peaks to one per contraction. Energy in the EMG was measured 50 ms either side of each envelope (contraction) peak. Energy values at 5% and 95% maximal defined EMG start and end time, respectively. The algorithm was as good as a person at identifying contractions during clonus (p = 0.946, n = 31 spasms, 7 subjects with cervical spinal cord injury), and marking start and end times to determine clonus frequency (intra class correlation coefficient, α: 0.949), contraction intensity using root mean square EMG (α: 0.997) and EMG duration (α: 0.852). On average the algorithm was 574 times faster than manual analysis performed independently by two people (p ≤ 0.001). This algorithm is an important tool for characterization of clonus in long-term EMG records.  相似文献
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目的探讨微血管减压术对手术疗效及并发症发生的影响。方法微血管减压手术治疗多种颅神经疾病965例,其中三叉神经痛482例,面肌痉挛461例,舌咽神经痛15例,蝶腭神经痛2例,耳鸣5例,通过此手术早期和后期并发症发生情况的比较,观察手术方法对并发症和疗效的影响。结果本组三叉神经痛患者手术有效率为97.3%,面肌痉挛手术有效率为96.3%,舌咽神经痛、蝶腭神经痛、耳鸣手术有效率为100%,手术方法的改良显著地减少了手术并发症的发生。结论微血管减压手术是对多种颅神经疾患有效。病人的选择(手术指征),手术技巧对手术疗效和并发症的有重要意义。  相似文献
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Tolperisone, a piperidine derivative, is assigned to the group of centrally acting muscle relaxants and has been in clinical use now for decades. The review summarizes the known pharmacokinetics, pharmacodynamics, toxicology and side effects in humans and the clinical use of tolperisone. A future perspective for further exploration of this drug is given.  相似文献
8.
目的 评价注射用A型肉毒毒素改善脑卒中亚急性期和恢复期肌肉痉挛和活动功能的效果比较.方法 选择2013年6月~2016年1月在我院就诊的脑卒中患者86例,根据病史长短分为亚急性期组(<1个月)37例和恢复期组(≥1个月)49例,均接受肉毒毒素200 U肌肉注射,疗程4周,评价治疗后改良Ashworth量表(MAS)、改良Tardieu量表(MTS)、徒手肌力检查法(MMT)、被动关节活动度(PROM)、Barthel指数和Fugl-Meyer量表.结果 所有患者均顺利接受治疗,两组随访时间分别为26(22~30)d和29(24~31)d,组间比较差异无统计学意义(Z=1.332,P=0.307);亚急性期组治疗后肘部、腕部MAS评分较疗前改善(P<0.05),而恢复期组MAS无明显差异(P>0.05),亚急性期组均优于恢复期组(P<0.05);亚急性期组治疗后肘部R1、D和腕部R1、R2均有改善(P<0.05),恢复期组治疗后MTS中肘部R1、D和腕部R1较治疗前改善(P<0.05),亚急性期组腕部R1、R2优于恢复期组(P<0.05);亚急性期组治疗后MMT肘部外展较治疗前改善(P<0.05),其他指标无改善;亚急性期组PROM腕部外展、腕部活动度较治疗前改善(P<0.05),恢复期组各指标治疗后无明显改善(P>0.05),亚急性组腕部外展优于恢复期组(P<0.05);亚急性期组Barthel指数、Fugl-Meyer和恢复期Fugl-Meyer较治疗前升高(P<0.05),但组间比较差异均无统计学意义(P>0.05).结论 肉毒毒素能改善脑卒中亚急性期和恢复期肌肉痉挛和功能,但亚急性期治疗效果更明显.  相似文献
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目的 探讨微血管减压术中持续监测异常肌反应对判断面肌痉挛责任血管、改善预后和减少术后并发症的意义.方法 34例面肌痉挛患者行微血管减压术,术中持续监测异常肌反应.结果 患者均于麻醉前诱导刺激面神经颧支,并于面神经颏支记录到异常肌反应.与术前相比,术后异常肌反应潜伏期延长[(16.12±3.17) ms对(14.75±3.32) ms,P=0.015]、波幅降低[(0.11 ±0.03) mV对(0.13±0.03) mV,P=0.027].32例(94.12%)分离责任血管后异常肌反应消失;1例(2.94%)切开硬脑膜后短暂性消失,至分离责任血管后完全消失;1例(2.94%)分离责任血管后仍仔在.责任血管分别为小脑前下动脉(30例,88.24%)、小脑后下动脉(3例,8.82%)和基底动脉(1例,2.94%),血管压迫面神经根部22例(64.71%)、远端8例(23.53%)、同时压迫根部和远端4例(11.76%).术后面肌痉挛症状均消失,至随访结束时,治愈31例、明显缓解2例、无效1例,治疗总有效率为97.06%.结论 术中持续监测异常肌反应有助于明确责任血管、更彻底地完成面神经减压、改善预后、减少迟发性愈合,同时可以提高术者信心,减少手术时间.  相似文献
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