Neurologisches Krankenhaus München, Center for Parkinson's disease and Movement Disorders, Parzivalplatz 4, D-80804 Munich, Germany.
Eur J Neurol. 2009 Dec;16(12):1299-304. doi: 10.1111/j.1468-1331.2009.02723.x. Epub 2009 Jun 29.
Severe generalized spastic movement disorders of various aetiologies often involve the jaw muscles and lead to a spastic trismus with masseter muscle hypertonia. We report a placebo-controlled randomized study on patients with spastic trismus.
Eleven patients with masseter hypertonia because of stroke, hypoxic encephalopathy or traumatic brain injury were allocated to either botulinum toxin serotype B (BoNT/B) injections into the masseter muscles or placebo treatment. The dental gap, the amount of saliva, salivation scales, and a clinical goal attainment were evaluated.
Three weeks after injection the BoNT/B group showed a significantly increased mouth opening compared with placebo treatment (P < 0.05). In addition to the muscle paralysing effect, a goal attainment scale demonstrated a clinical benefit for the BoNT/B group (P < 0.01).
Botulinum toxin serotype B injections into the masseter muscles effectively reduce hypertonia and provide for better mouth opening, thereby contributing to a positive and desired clinical goal.
多种病因引起的严重全身性痉挛运动障碍常累及咀嚼肌，导致咀嚼肌痉挛性牙关紧闭和咬肌张力亢进。我们报告了一项针对痉挛性牙关紧闭患者的安慰剂对照随机研究。
11 名因中风、缺氧性脑病或外伤性脑损伤而出现咬肌张力亢进的患者被分配到肉毒杆菌毒素 B 型（BoNT/B）注射到咬肌或安慰剂治疗组。评估了牙间隙、唾液量、唾液量表和临床目标达成情况。
注射后 3 周，BoNT/B 组的张口度明显大于安慰剂组（P<0.05）。除了肌肉瘫痪作用外，目标达成量表还显示 BoNT/B 组具有临床益处（P<0.01）。
BoNT/B 注射到咬肌中可有效降低肌张力亢进，并提供更好的张口度，从而有助于实现积极和理想的临床目标。
