Greene P E, Fahn S
Dystonia Clinical Research Center, Columbia Presbyterian Medical Center, New York, New York.
Mov Disord. 1992;7(1):48-52. doi: 10.1002/mds.870070109.
Baclofen benefits some patients with adult onset dystonia, but few reports document the response to baclofen of children with idiopathic dystonia. Sixteen of 80 patients less than age 21 years with idiopathic dystonia seen by the Movement Disorder Group at Columbia-Presbyterian Medical Center in New York were treated with baclofen. Five had substantial improvement in symptoms, two had moderate improvement, and nine failed to benefit. Three of the improved patients had transient improvement on high dose anticholinergics, but had sustained, dramatic improvement when baclofen was added. At last follow-up, five patients maintained improvement for a mean 3.8 years (19 months-8 years) on a mean 79 mg of baclofen (40-120 mg). Response to baclofen did not correlate with age at onset of dystonia or age at onset of therapy, but did correlate with duration of symptoms before therapy (3 years for those who improved vs 7.8 years for those who did not: p less than .002 by t-test). Baclofen can be an effective treatment for childhood dystonia.
巴氯芬对一些成年起病的肌张力障碍患者有益,但很少有报告记录特发性肌张力障碍儿童对巴氯芬的反应。纽约哥伦比亚长老会医学中心运动障碍小组诊治的80例21岁以下的特发性肌张力障碍患者中,有16例接受了巴氯芬治疗。5例症状有显著改善,2例有中度改善,9例无效。3例症状改善的患者在服用高剂量抗胆碱能药物时有短暂改善,但加用巴氯芬后症状持续、显著改善。在最后一次随访时,5例患者在平均79毫克(40 - 120毫克)的巴氯芬治疗下平均改善了3.8年(19个月至8年)。对巴氯芬的反应与肌张力障碍起病年龄或治疗开始年龄无关,但与治疗前症状持续时间有关(改善者为3年,未改善者为7.8年:经t检验,p小于0.002)。巴氯芬对儿童肌张力障碍可能是一种有效的治疗方法。