Lim E C-H, Seet R C S
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, and National University Hospital, Singapore.
Acta Neurol Scand. 2008 Feb;117(2):73-84. doi: 10.1111/j.1600-0404.2007.00931.x. Epub 2007 Sep 11.
The benefits derived from botulinum toxin (BTX) injections may be negated by unintentional weakness of adjacent uninjected muscles. Such weakness may be the result of inaccurate targeting, or diffusion of BTX to surrounding muscles. Several techniques, using electromyographic, endoscopic or imaging guidance are purported to increase the accuracy of targeting. Diffusion of BTX is thought to be influenced by factors such as dose, concentration, injectate volume, number of injections, site and rate of injection, needle gauge, muscle size, muscular fascia, distance of needle tip from the neuromuscular junction, and protein content of the BTX formulation. This article describes techniques that aim to increase the accuracy of BTX injections and examines the controversies surrounding diffusion of BTX following injection.
肉毒杆菌毒素（BTX）注射所带来的益处可能会因相邻未注射肌肉的意外无力而抵消。这种无力可能是由于靶向不准确，或BTX扩散至周围肌肉所致。有几种使用肌电图、内镜或成像引导的技术据称可提高靶向的准确性。BTX的扩散被认为受多种因素影响，如剂量、浓度、注射量、注射次数、注射部位和速率、针的规格、肌肉大小、肌筋膜、针尖与神经肌肉接头的距离以及BTX制剂的蛋白质含量。本文介绍了旨在提高BTX注射准确性的技术，并探讨了注射后BTX扩散相关的争议。
