Oleszek Joyce L, Chang Nicki, Apkon Susan D, Wilson Pamela E
Department of Physical Medicine and Rehabilitation, Children's Hospital, Denver, Colorado 80218, USA.
Am J Phys Med Rehabil. 2005 Oct;84(10):813-6. doi: 10.1097/01.phm.0000179516.45373.c4.
This is a retrospective case series describing the use of botulinum toxin type A in the treatment of children with congenital muscular torticollis who fail to progress with conservative management. A total of 27 children with congenital muscular torticollis, 6-18 mos of age, received 30 botulinum toxin type A injections into their sternocleidomastoid or upper trapezius muscle, or both, at a pediatric tertiary care center between 1995 and 2001. Three children received repeat injections. Twenty of 27 children (74%) had improved cervical rotation or head tilt after the injections, and 2 of 27 (7%) experienced transient adverse events, specifically, mild dysphagia and neck weakness. This series suggests that botulinum toxin type A may be a safe and effective treatment option for children with congenital muscular torticollis who are unresponsive to a traditional regimen of physical therapy and a home program. A prospective, randomized controlled trial is necessary to definitively assess the role of botulinum toxin type A in this population.
这是一篇回顾性病例系列研究，描述了A型肉毒杆菌毒素在治疗先天性肌性斜颈且保守治疗无效儿童中的应用。1995年至2001年期间，在一家儿科三级护理中心，共有27名年龄在6至18个月的先天性肌性斜颈儿童接受了30次A型肉毒杆菌毒素注射，注射部位为胸锁乳突肌或斜方肌上部，或两者均注射。3名儿童接受了重复注射。27名儿童中有20名（74%）在注射后颈部旋转或头部倾斜得到改善，27名中有2名（7%）经历了短暂的不良事件，具体为轻度吞咽困难和颈部无力。该系列研究表明，对于对传统物理治疗方案和家庭训练无反应的先天性肌性斜颈儿童，A型肉毒杆菌毒素可能是一种安全有效的治疗选择。有必要进行一项前瞻性随机对照试验，以明确评估A型肉毒杆菌毒素在该人群中的作用。
