Pacchetti C, Mancini F, Bulgheroni M, Zangaglia R, Cristina S, Sandrini G, Nappi G
Parkinson's Disease and Movement Disorder Center, Neurological Institute IRCCS C. Mondino, University of Pavia, Via Palestro 3, I-27100 Pavia, Italy.
Neurol Sci. 2000 Dec;21(6):349-53. doi: 10.1007/s100720070049.
This study aimed to improve botulinum toxin's (BTX) efficacy and to reduce its unwanted effects in the treatment of functional disability due to essential tremor (ET) of the hand. Twenty patients with disabling ET, not responding to conventional pharmacological therapy, were enrolled in this open-label study. Activities of daily living self-questionnaire (ADLS) and severity tremor scale (STS) were used to establish patients' functional disability and tremor severity. Accelerometry and surface electromyography were used to identify the arm muscles with tremorogenic activity during impaired positions. Global rating was used to measure treatment efficacy and unwanted effects. BTX type A was injected into the muscles principally responsible for impaired positions. After BTX treatment, there was a significant reduction in both severity and functional rating scales scores (ADLS and STS) and of tremor amplitude as measured with accelerometry and EMG. Adverse effects were limited to a slight third finger extension weakness in 15% of patients. BTX injections are effective and safe in reducing disability due to ET, if based on the criterion of functional selection.
本研究旨在提高肉毒杆菌毒素（BTX）在治疗手部特发性震颤（ET）所致功能障碍方面的疗效，并减少其不良反应。20例对传统药物治疗无反应的致残性ET患者纳入了这项开放标签研究。采用日常生活自我调查问卷（ADLS）和震颤严重程度量表（STS）来确定患者的功能障碍和震颤严重程度。使用加速度计和表面肌电图来识别在姿势受损期间具有震颤活动的手臂肌肉。采用整体评分来衡量治疗效果和不良反应。将A型BTX注射到主要导致姿势受损的肌肉中。BTX治疗后，严重程度和功能评分量表（ADLS和STS）得分以及通过加速度计和肌电图测量的震颤幅度均显著降低。不良反应仅限于15%的患者出现轻微的无名指伸展无力。如果基于功能选择标准，BTX注射在减少ET所致残疾方面是有效且安全的。
