Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, London, UK.
Mov Disord. 2011 Jul;26(8):1410-4. doi: 10.1002/mds.23671. Epub 2011 Apr 11.
Fixed dystonia is a disabling disorder mainly affecting young women who develop fixed abnormal limb postures and pain after apparently minor peripheral injury. There is continued debate regarding its pathophysiology and management. We report 5 cases of fixed dystonia in patients who sought amputation of the affected limb. We place these cases in the context of previous reports of patients with healthy limbs and patients with chronic regional pain syndrome who have sought amputation. Our cases, combined with recent data regarding disorders of mental rotation in patients with fixed dystonia, as well as previous data regarding body integrity identity disorder and amputations sought by patients with chronic regional pain syndrome, raise the possibility that patients with fixed dystonia might have a deficit in body schema that predisposes them to developing fixed dystonia and drives some to seek amputation. The outcome of amputation in fixed dystonia is invariably unfavorable.
固定性肌张力障碍是一种致残性疾病，主要影响年轻女性，她们在外周轻微损伤后会出现固定的异常肢体姿势和疼痛。其病理生理学和治疗方法仍存在争议。我们报告了 5 例固定性肌张力障碍患者寻求截肢的病例。我们将这些病例与之前报告的健康肢体患者和慢性区域性疼痛综合征患者寻求截肢的病例进行了比较。我们的病例，以及最近关于固定性肌张力障碍患者心理旋转障碍的研究数据，以及之前关于慢性区域性疼痛综合征患者寻求截肢的身体完整性认同障碍的研究数据，提示固定性肌张力障碍患者可能存在躯体图式缺陷，使他们易患固定性肌张力障碍，并促使一些患者寻求截肢。固定性肌张力障碍患者的截肢结果总是不利的。
