Racette B A, Lopate G, Good L, Sagitto S, Perlmutter J S
Department of Neurology and Neurological Surgery, Washington University Sxhool of Medicine, St. Louis, MO 63110, USA.
Neurology. 2002 Nov 12;59(9):1445-7. doi: 10.1212/wnl.59.9.1445.
The authors report a patient with cervical dystonia, previously treated with botulinum toxin A (BTX-A), who developed bilateral ptosis and difficulty with accommodation only after botulinum toxin B (BTX-B). High-frequency repetitive nerve stimulation of the abductor digiti minimi demonstrated a 34% increment in compound muscle action potential. No increment in 20 people injected with BTX-A and no cases of ptosis in a chart review of 1,606 BTX-A injections for cervical dystonia were found. The authors conclude that systemic spread of BTX-B can cause symptomatic involvement of autonomic neurons.
作者报告了一名患有颈部肌张力障碍的患者，此前接受过A型肉毒毒素（BTX-A）治疗，仅在接受B型肉毒毒素（BTX-B）治疗后出现双侧上睑下垂和调节困难。对小指展肌进行高频重复神经刺激显示复合肌肉动作电位增加了34%。在对1606例用于颈部肌张力障碍的BTX-A注射进行图表回顾时，未发现20例接受BTX-A注射的患者有电位增加情况，也未发现上睑下垂病例。作者得出结论，BTX-B的全身扩散可导致自主神经元出现症状性受累。
