Greene P, Kang U, Fahn S, Brin M, Moskowitz C, Flaster E
Dystonia Clinical Research Center, Columbia Presbyterian Medical Center, New York, NY.
Neurology. 1990 Aug;40(8):1213-8. doi: 10.1212/wnl.40.8.1213.
We enrolled 55 patients in a double-blind, placebo-controlled, parallel design study of the effectiveness of botulinum toxin (Botox) injections for the treatment of spasmodic torticollis. Patients received a standard series of injections, either placebo or Botox. We determined the sites of injection and dose per muscle by the nature of head deviation. Compared with placebo, Botox produced statistically significant improvement in the severity of torticollis, disability, pain, and degree of head turning. There were no serious side effects. During the double-blind phase, 61% of patients injected with Botox improved; 74% of patients subsequently improved during a later open phase at a higher dose of Botox. Direction of head turning, severity of torticollis, and presence or absence of jerky movements did not significantly influence the response rate. We conclude that Botox is a valuable treatment for spasmodic torticollis.
我们招募了55名患者，进行一项双盲、安慰剂对照、平行设计的研究，以评估肉毒杆菌毒素（保妥适）注射治疗痉挛性斜颈的有效性。患者接受了标准系列注射，注射的要么是安慰剂，要么是保妥适。我们根据头部偏斜的性质确定注射部位和每块肌肉的剂量。与安慰剂相比，保妥适在斜颈严重程度、功能障碍、疼痛和头部转动程度方面产生了具有统计学意义的改善。没有严重的副作用。在双盲阶段，61%接受保妥适注射的患者病情有所改善；随后在更高剂量保妥适的开放阶段，74%的患者病情得到改善。头部转动方向、斜颈严重程度以及是否存在抽搐动作对缓解率没有显著影响。我们得出结论，保妥适是治疗痉挛性斜颈的一种有效疗法。
