Park Eun Sook, Park Chang Il, Kim Deog Young, Kim Yong Rae
Rehabilitation Department, Yonsei University College of Medicine, #120-752 Seoul, Korea.
Arch Phys Med Rehabil. 2002 Nov;83(11):1592-6. doi: 10.1053/apmr.2002.34623.
To evaluate the changes in cortical somatosensory-evoked potentials (SEPs) after botulinum toxin type A injection to determine what effect spasticity has on cortical SEPs.
Intervention study and before-after trial.
University-affiliated hospital in Korea.
Twelve children with spastic hemiplegic cerebral palsy (CP), 7 children with spastic diplegic CP, and 8 patients with traumatic brain injury.
All participants had botulinum toxin type A injected into the muscles of the spastic limb.
SEPs were recorded before and 7 days after the botulinum toxin type A injection. Spasticity of the affected spastic limb was also measured. The short latency and amplitude of waves in SEPs were measured. The SEP results were divided into 3 groups: flat (no evoked potential), abnormal (evoked but delayed in latency), and normal (clear waveform with normal latency).
The normal response of cortical SEP increased after injection. The SEPs exhibited more frequent improvement in the limbs, with greater improvement of spasticity in grade (>1.0 grade) and in patients of younger age (<3y) after injection (P<.05).
The observed improvement of cortical SEPs with associated reduction of spasticity that occurred after the botulinum toxin type A injection indicates that spasticity itself can be considered a factor affecting cortical SEPs.
评估A型肉毒毒素注射后皮质体感诱发电位（SEP）的变化，以确定痉挛对皮质SEP有何影响。
干预性研究及前后对照试验。
韩国一家大学附属医院。
12例痉挛型偏瘫脑瘫患儿、7例痉挛型双瘫脑瘫患儿和8例创伤性脑损伤患者。
所有参与者均接受A型肉毒毒素注射到痉挛肢体的肌肉中。
在注射A型肉毒毒素前及注射后7天记录SEP。同时测量患侧痉挛肢体的痉挛程度。测量SEP中各波的短潜伏期和波幅。SEP结果分为3组：平坦型（无诱发电位）、异常型（有诱发电位但潜伏期延迟）和正常型（波形清晰且潜伏期正常）。
注射后皮质SEP的正常反应增加。SEP在肢体上的改善更为频繁，注射后痉挛程度分级较高（>1.0级）及年龄较小（<3岁）的患者痉挛改善更明显（P<0.05）。
A型肉毒毒素注射后观察到的皮质SEP改善以及伴随的痉挛程度减轻表明，痉挛本身可被视为影响皮质SEP的一个因素。
