Tani Makiko, Suzuki Toshiaki, Takada Aya, Yagyu Takami, Kinoshita Toshihiko
Department of Neuropsychiatry, Kansai Medical University.
Seishin Shinkeigaku Zasshi. 2005;107(8):802-10.
We performed acupuncture treatment on first consultation for a female 28-year-old patient with severe axial dystonia, causing involuntary movement and abnormal posture of the neck and body, which had developed during treatment for schizophrenia. Involuntary movement involving elevation of the right shoulder began to occur in October X-1. Drugs were prescribed by her doctor, but her involuntary movement worsened and spread to the whole body. Thereafter, she began receiving acupuncture treatment at the out patient clinic for dystonia at the Kansai Medical College Hospital in July X. Involuntary movements of her neck involved repeated left lateral bending or a rigidly straight posture while sitting and standing. Her neck also showed a left lateral bend and right rotation. Her body showed a left lateral bend and right shoulder elevation. The neck problems in this case were induced by a hypertonicity of the left sternocleidomastoid (SCM), which caused the left lateral bending and right rotation of the neck. Problems in her body involved left lateral bending due to hypotonicity of the left abdominal muscle and hypotonicity of the left back muscles, which were unable to control the left lateral bending of the body. The right shoulder elevation was caused by a hypertonicity of the right trapezius and this was another of her problems. Acupuncture treatments were given using a penetrating needle method. The treatment points were left LI4 to decrease the hypertonicity of the left SCM, left ST41 to increase the hypotonicity of the left abdominal muscles, right BL60 to increase the hypotonicity of the right back muscles and right TE5 to decrease the hypertonicity of the right trapezius. At the initial stage of acupuncture treatment, the patient was not able to attend the hospital regularly enough to obtain sufficient improvement by acupuncture. In December X+1, she started to receive acupuncture treatment weekly, and the posture of the neck and body improved. In May X+3, her neck and body postures remained erect while sitting and she did not show involuntary movement. For problems of dystonia, we perform acupuncture treatment, using meridian and acupressure points selected based on the oriental medicine system, and we achieved improvement of symptoms in this case. The patient also achieved improved stability with regard to the symptoms of schizophrenia. It is suggested that acupuncture treatment has had a positive effect on tardive dystonia including axial dystonia.
我们对一名28岁的严重轴性肌张力障碍女性患者进行了初诊针灸治疗。该患者在精神分裂症治疗期间出现颈部和身体的不自主运动及异常姿势。右肩部抬高的不自主运动于X - 1年10月开始出现。其医生开了药，但她的不自主运动恶化并蔓延至全身。此后，她于X年7月开始在关西医科大学医院的肌张力障碍门诊接受针灸治疗。她颈部的不自主运动包括坐着和站立时反复向左侧弯或呈僵硬挺直姿势。她的颈部还呈现左侧弯和右旋。她的身体表现为左侧弯和右肩部抬高。该病例中颈部问题是由左侧胸锁乳突肌（SCM）张力亢进引起，导致颈部左侧弯和右旋。她身体的问题包括左侧腹肌张力减退和左侧背部肌肉张力减退导致的左侧弯，这使得身体无法控制左侧弯。右肩部抬高是由右侧斜方肌张力亢进引起，这是她的另一个问题。针灸治疗采用透针法。治疗穴位为左侧合谷（LI4）以降低左侧SCM的张力亢进，左侧足三里（ST41）以增强左侧腹肌的张力减退，右侧昆仑（BL60）以增强右侧背部肌肉的张力减退，右侧外关（TE5）以降低右侧斜方肌的张力亢进。在针灸治疗初期，患者无法足够规律地就诊以通过针灸获得充分改善。在X + 1年12月，她开始每周接受针灸治疗，颈部和身体姿势得到改善。在X + 3年5月，她坐着时颈部和身体姿势保持挺直，未出现不自主运动。对于肌张力障碍问题，我们根据中医系统选择经络和穴位进行针灸治疗，在此病例中症状得到改善。该患者在精神分裂症症状方面也实现了更好的稳定性。提示针灸治疗对包括轴性肌张力障碍在内的迟发性肌张力障碍有积极作用。
