Physical Medicine and Rehabilitation Department, AP-HP, GH Bichat, University Paris7, Paris, France.
Eur J Phys Rehabil Med. 2010 Sep;46(3):401-10.
Spasticity is a common symptom observed after pyramidal system lesion. The treatment of spasticity has considerably changed during last years, notably with the generalization of Botulinum toxin use. However, the treatment of spasticity should consider all therapeutic possibility in accordance with patient status and objective. Drugs are only a part of the treatment and physical therapy must always be used. Others treatments such as surgery, orthosis, occupational therapy must also be discussed individually. Several guidelines are now available for Botulinum toxin treatment but only the French guidelines consider all drug therapies. This review addresses the different drugs commonly used on the basis of an extensive review of literature. Some facts are clearly established by randomized controlled trials but a certain number of questions remains unclear and only clinical experience and consensus can guide injectors.
痉挛是锥体系统损伤后常见的症状。近年来，痉挛的治疗发生了很大的变化，特别是肉毒毒素的广泛应用。然而，痉挛的治疗应根据患者的状况和客观情况考虑所有的治疗可能性。药物只是治疗的一部分，物理治疗必须始终使用。其他治疗方法，如手术、矫形器、职业治疗也必须单独讨论。目前有几个关于肉毒毒素治疗的指南，但只有法国指南考虑了所有的药物治疗。这篇综述根据文献的广泛回顾，讨论了常用的不同药物。一些事实已经通过随机对照试验得到明确确立，但仍有一些问题尚不清楚，只有临床经验和共识才能指导注射者。
