Gordon Paul H, Gooch Clifton L, Greene Paul E
Department of Neurology, ACC-2, University of New Mexico, 915 Camino de Salud NE, Albuquerque, New Mexico 87131, USA.
Muscle Nerve. 2002 Dec;26(6):828-31. doi: 10.1002/mus.10231.
We studied 22 patients with dystonia to determine the normal range of values for the extensor digitorum brevis (EDB) test, and to determine its sensitivity and specificity in detecting resistance to botulinum toxin type A (BTX-A). Three compound muscle action potentials (CMAPs) elicited by peroneal nerve stimulation were averaged before and 2 weeks after injection of 20 units of BTX-A into the EDB. Amplitude and area ratios were calculated by dividing the averaged postinjection CMAP by the averaged preinjection CMAP values. The difference in means of this ratio between clinically sensitive and resistant subjects was statistically significant (P < 0.002). A normal range of <0.45 for each ratio was determined by adding two standard deviations to the ratio mean of 14 clinically sensitive subjects. Four of five resistant patients had values outside the normal range. The EDB test is a simple quantitative method of detecting resistance to BTX-A, with a sensitivity of 80% and specificity of 94%.
我们研究了22例肌张力障碍患者，以确定趾短伸肌（EDB）试验的正常数值范围，并确定其在检测对A型肉毒毒素（BTX-A）耐药性方面的敏感性和特异性。在向EDB注射20单位BTX-A之前和之后2周，分别对腓总神经刺激引发的三个复合肌肉动作电位（CMAP）进行平均。通过将注射后平均CMAP除以注射前平均CMAP值来计算幅度和面积比。临床敏感和耐药受试者之间该比值的均值差异具有统计学意义（P < 0.002）。通过将14例临床敏感受试者的比值均值加上两个标准差，确定每个比值的正常范围<0.45。五例耐药患者中有四例的值超出正常范围。EDB试验是一种检测对BTX-A耐药性的简单定量方法，敏感性为80%，特异性为94%。
