Jang Dae-Hyun, Sung In Young, Kang Yu Jeong
Department of Rehabilitation, Incheon St. Mary's Hospital, Catholic University of Korea, Korea.
J Child Neurol. 2013 Jan;28(1):21-6. doi: 10.1177/0883073812450615. Epub 2012 Jul 25.
This study sought to investigate the relationships between clinical and neurophysiologic assessments of spasticity after injection of botulinum toxin-A in children with cerebral palsy. A total of 40 children were recruited. Clinical assessments included the modified Ashworth scale and modified Tardieu scale parameters R1, R2, and D. Neurophysiologic assessment included compound motor action potential, Hoffmann, and tendon reflex. Children showed significant decreases in modified Ashworth scale, R1, and R2 at 2, 4, and 12 weeks and in D at 2 and 4 weeks. Amplitude of compound motor action potential decreased at 2 weeks, Hoffmann reflex amplitude decreased at 4 weeks, and tendon reflex amplitude decreased at 2 and 4 weeks. At 12 weeks, none of the neurophysiologic parameters differed from baseline. The correlations among R2, D, and the amplitude of tendon reflex were significant. Neurophysiologic tests could be used to evaluate reduced spasticity after botulinum toxin-A injection. The amplitude of tendon reflex showed the highest correlation with severity of spasticity.
本研究旨在探讨注射肉毒杆菌毒素-A后，脑瘫患儿痉挛的临床评估与神经生理学评估之间的关系。共招募了40名儿童。临床评估包括改良Ashworth量表以及改良Tardieu量表参数R1、R2和D。神经生理学评估包括复合运动动作电位、霍夫曼征和腱反射。患儿在2周、4周和12周时改良Ashworth量表、R1和R2显著降低，在2周和4周时D显著降低。复合运动动作电位幅度在2周时降低，霍夫曼反射幅度在4周时降低，腱反射幅度在2周和4周时降低。在12周时，神经生理学参数均与基线无差异。R2、D与腱反射幅度之间的相关性显著。神经生理学测试可用于评估肉毒杆菌毒素-A注射后痉挛的减轻情况。腱反射幅度与痉挛严重程度的相关性最高。
