Jankovic Joseph
Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA.
Mov Disord. 2004 Mar;19 Suppl 8:S109-15. doi: 10.1002/mds.20024.
Cervical dystonia (CD) is the most common form of dystonia encountered in a movement disorders clinic. The treatment of this focal dystonia has improved markedly with the advent on botulinum toxin (BTX) injections, which has now become the treatment of choice. Initial studies, even double-blind controlled trials, failed to show robust effect, largely as a result of poor design, often using fixed dosage and site of administration. When the BTX treatment is customized to the needs of the individual patients and the most involved muscles are targeted, the effects can be quite dramatic and the improvement usually lasts 3 to 4 months. Experience and improved skills can largely prevent the adverse effects such as dysphagia and neck weakness. Although there is no evidence that BTX slows the progression of the disease, as a result of early intervention with BTX, many of the long-term complications of CD, such as contractures and radiculopathy, have been largely eliminated.
颈部肌张力障碍（CD）是运动障碍门诊中最常见的肌张力障碍形式。随着肉毒杆菌毒素（BTX）注射疗法的出现，这种局限性肌张力障碍的治疗有了显著改善，BTX注射现已成为首选治疗方法。早期研究，甚至双盲对照试验，都未能显示出显著效果，这主要是由于设计不佳，常常采用固定剂量和给药部位。当根据个体患者的需求定制BTX治疗方案并针对受累最严重的肌肉进行注射时，效果会非常显著，且改善通常可持续3至4个月。经验的积累和技术的提高在很大程度上可以预防诸如吞咽困难和颈部无力等不良反应。虽然没有证据表明BTX能减缓疾病进展，但由于早期使用BTX进行干预，CD的许多长期并发症，如挛缩和神经根病，已基本消除。
