Sloop R R, Cole D, Patel M C
Department of Neurology, Loma Linda University School of Medicine, California, USA.
Mov Disord. 2001 Jan;16(1):100-5. doi: 10.1002/1531-8257(200101)16:1<100::aid-mds1021>3.0.co;2-g.
We sought to determine whether the response to varying doses of botulinum toxin type A (BTX-A) injected in BTX-A-treated torticollis patients differed from the same injections given in toxin-naive individuals. We have developed a technique to objectively measure muscle weakness resulting from BTX injections in humans and have validated the technique in those not previously treated with BTX. We now examine BTX-A-treated torticollis patients to see if their response to BTX-A injection is similar to that of toxin-naive individuals. We injected 11 torticollis patients who had been receiving BTX-A injections with a standard 5-mouse unit (mu) dose into one extensor digitorum brevis (EDB) muscle and a varying dose into the other EDB, measuring muscle paralysis 2 weeks after the injection. Nine of the 11 patients were clinical and electrophysiologic responders. Two patients were non-responders. In the 9 responding patients the dose response curve to increasing doses of BTX-A was very similar to that seen in toxin-naive individuals. The mean muscle paralysis from the standard 5 mu dose was also similar to that previously reported in toxin-naive individuals. Torticollis patients who continue to respond clinically to BTX-A injections demonstrate essentially the same degree of muscle paralysis from the EDB injections as do subjects who have never been exposed to BTX-A.
我们试图确定肉毒杆菌毒素A（BTX-A）治疗斜颈患者时，不同剂量注射的反应与从未接触过毒素的个体接受相同注射时的反应是否不同。我们开发了一种技术来客观测量人类BTX注射引起的肌肉无力，并已在未接受过BTX治疗的个体中验证了该技术。我们现在检查接受BTX-A治疗的斜颈患者，看他们对BTX-A注射的反应是否与未接触过毒素的个体相似。我们给11名接受BTX-A注射的斜颈患者，在一侧趾短伸肌（EDB）中注射标准的5鼠单位（mu）剂量，在另一侧EDB中注射不同剂量，在注射后2周测量肌肉麻痹情况。11名患者中有9名在临床和电生理方面有反应。2名患者无反应。在9名有反应的患者中，对增加剂量的BTX-A的剂量反应曲线与未接触过毒素的个体中所见的非常相似。标准5 mu剂量引起的平均肌肉麻痹也与之前在未接触过毒素的个体中报道的相似。继续对BTX-A注射有临床反应的斜颈患者，EDB注射引起的肌肉麻痹程度与从未接触过BTX-A的受试者基本相同。
