Monnier G, Parratte B, Tatu L, Cosson A, Michel F, Metton G
Explorations et pathologies neuromusculaires, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France.
Ann Readapt Med Phys. 2003 Jul;46(6):380-5. doi: 10.1016/s0168-6054(03)00102-8.
The aim of this work is to sum up how the use of EMG improves BT therapy.
A systematic review of the literature in the Pub Med computer database, along with a manual biography, allowed us to choose the most synthetic and the most pertinent publications according to our own practical experience.
There is no consensus of opinion, but the great majority of authors emphasize the importance of EMG in the different stages of botulinum toxin treatment: before injections, at the time of the injection, and finally during the follow-up after the first injection or after the repeated injections that transient efficiency make necessary.
A symptomatic therapeutic means recently recognized in focal dystonias and spasticity, BT is injected locally into the muscles to be treated. EMG can be used: at pre-injection for physiopathological evaluation but above all to establish a diagnosis and precise pre-intervention evaluation; at the moment of injection to provide guidance in precise muscle selection and for maximum efficiency with reduced, therefore less costly, doses. It also limits the risk of product diffusion susceptible of causing iatrogenic side effects and/or auto-immunisation resulting in resistance to the toxin; during follow-up, to understand why treatment failed and to look for changes in the dystonia pattern leading to objective re-evaluations and adapted reinjections. Although neglected by some, electrological logistics seem to us, as to many other practitioners who inject, to be a considerably helpful aid, particularly at the moment of injection when targeting the muscle to be treated.
这项工作的目的是总结肌电图（EMG）的使用如何改善肉毒杆菌毒素（BT）治疗。
通过对PubMed计算机数据库中的文献进行系统综述，并结合人工检索文献，根据我们自己的实践经验，选择最综合、最相关的出版物。
目前尚无共识，但绝大多数作者强调肌电图在肉毒杆菌毒素治疗不同阶段的重要性：注射前、注射时，以及首次注射或多次重复注射后随访期间，因为短暂的疗效使得重复注射成为必要。
肉毒杆菌毒素是一种最近在局灶性肌张力障碍和痉挛中被认可的对症治疗手段，通过局部注射到待治疗的肌肉中发挥作用。肌电图可用于：注射前进行生理病理评估，但最重要的是用于诊断和精确的干预前评估；注射时为精确选择肌肉提供指导，以减少剂量从而降低成本的同时实现最大疗效。它还能降低产品扩散的风险，否则可能会导致医源性副作用和/或自身免疫，进而产生毒素耐药性；在随访期间，用于了解治疗失败的原因，并寻找肌张力障碍模式的变化，从而进行客观的重新评估和调整再次注射。尽管有些医生对此有所忽视，但对我们以及许多其他注射治疗的从业者来说，电生理学操作似乎是一种非常有用的辅助手段，尤其是在注射时确定待治疗肌肉的位置。
