用抗心律失常药物治疗肌强直。

Treatment of myotonia with antiarrhythmic drugs.

作者信息

Kwieciński H, Ryniewicz B, Ostrzycki A

机构信息

Department of Neurology, Warsaw Medical Academy, Poland.

出版信息

Acta Neurol Scand. 1992 Oct;86(4):371-5. doi: 10.1111/j.1600-0404.1992.tb05103.x.

DOI:10.1111/j.1600-0404.1992.tb05103.x

PMID:1455983

Abstract

The effects of disopyramide, phenytoin, mexiletine, and tocainide were compared in 30 patients with myotonic disorders. The severity of myotonia was assessed by clinical and electromyographic criteria at the end of each treatment phase lasting four weeks. Mexiletine (MXT) and tocainide (TCD) were found to be the most potent antimyotonic agents. The antimyotonic efficacy of MXT and TCD is explained by their fast-blocking effect on voltage-dependent sodium channels in the muscle membrane. The benefits of myotonia control with pharmacological agents must be weight against the risk of therapy in the individual patient. Because of the risks of hematologic problems, TCD is not recommended by us for the treatment of myotonia.

摘要

在30例肌强直障碍患者中比较了丙吡胺、苯妥英、美西律和妥卡尼的效果。在每个为期四周的治疗阶段结束时，通过临床和肌电图标准评估肌强直的严重程度。发现美西律（MXT）和妥卡尼（TCD）是最有效的抗肌强直药物。MXT和TCD的抗肌强直疗效可通过它们对肌膜中电压依赖性钠通道的快速阻断作用来解释。使用药物控制肌强直的益处必须与个体患者的治疗风险相权衡。由于存在血液学问题的风险，我们不推荐使用TCD治疗肌强直。