Hoon A H, Freese P O, Reinhardt E M, Wilson M A, Lawrie W T, Harryman S E, Pidcock F S, Johnston M V
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Pediatr Neurol. 2001 Jul;25(1):55-8. doi: 10.1016/s0887-8994(01)00287-9.
Trihexyphenidyl (Artane) is a centrally active muscarinic antagonist commonly used to treat patients with generalized dystonia. In a retrospective survey of 22 consecutive children with extrapyramidal cerebral palsy, we evaluated trihexyphenidyl on upper extremity and lower extremity function, expressive language, and drooling. Functional changes were assessed using a parental questionnaire (rating scale 1-5: from 1 = little or no change to 5 = tremendous change, with scores in either a positive or negative direction). Improvements of +4 or +5 were reported in eight children for upper extremity function, in eight children for verbal expressive language, in five for drooling, and in none for lower extremity function. Using bivariate linear regression modeling to investigate variables associated with treatment effects, there was a significant inverse relationship between age at initiation of medication and therapeutic response. Furthermore, beneficial responses were specific to upper-extremity function and expressive language. These results suggest that younger children are more likely to respond to trihexyphenidyl and that primary functional benefits include improved fine motor abilities and expressive language. A prospective masked study with a standardized clinical instrument is needed to confirm these findings.
苯海索（安坦）是一种中枢性作用的毒蕈碱拮抗剂，常用于治疗全身性肌张力障碍患者。在一项对22例连续性锥体外系脑性瘫痪患儿的回顾性调查中，我们评估了苯海索对上肢和下肢功能、表达性语言及流涎的影响。使用家长问卷评估功能变化（评分量表1 - 5：1 = 几乎无变化或无变化，5 = 巨大变化，评分可呈正向或负向）。上肢功能方面，8名儿童报告有 +4或 +5的改善；言语表达性语言方面，8名儿童有改善；流涎方面，5名儿童有改善；下肢功能方面，无儿童有改善。使用双变量线性回归模型研究与治疗效果相关的变量，开始用药时的年龄与治疗反应之间存在显著的负相关关系。此外，有益反应特定于上肢功能和表达性语言。这些结果表明，年龄较小的儿童更可能对苯海索有反应，主要的功能益处包括精细运动能力和表达性语言的改善。需要进行一项使用标准化临床工具的前瞻性双盲研究来证实这些发现。
