Division of Pediatric Neurology, Montreal Children's Hospital-McGill University Health Center, McGill University, Montreal, Quebec, Canada.
Curr Treat Options Neurol. 2012 Dec;14(6):650-9. doi: 10.1007/s11940-012-0192-7.
Spasticity affects up to 80 % of patients with cerebral palsy (CP) and often plays a significant role in limiting the child's ability to function and participate in daily activities. The treatment of spasticity involves a multifaceted approach that includes pharmacological treatment with antispasmodics, physical therapy to maintain range of motion and prevent contractures, as well as a variety of orthopedic and neurosurgical interventions. Pharmacological agents currently used in clinical practice to treat spasticity in children have existed for almost two decades and continue to be used despite lack of solid evidence for their efficacy. Studies detailing safety profiles and optimal dosing in the pediatric population are greatly warranted. Intramuscular injection of botulinum neurotoxin is becoming increasingly popular for the treatment of segmental spasticity and current literature suggests it is safe and effective (Level A). Constraint-induced movement therapy (CIMT) and repetitive transcranial magnetic stimulation (rTMS) are emerging as effective interventions in improving motor function in hemiplegic CP. However, the role of these as of yet >interventions in reducing spasticity remains to be clarified.
痉挛影响高达 80%的脑瘫（CP）患者，常常严重限制患儿的功能和日常活动能力。痉挛的治疗涉及多方面的方法，包括使用抗痉挛药物的药物治疗、保持运动范围和预防挛缩的物理治疗，以及各种矫形和神经外科干预。目前用于治疗儿童痉挛的临床药物已存在近 20 年，尽管缺乏其疗效的确凿证据，但仍在继续使用。详细描述儿科人群的安全性概况和最佳剂量的研究是非常必要的。肉毒毒素肌内注射治疗节段性痉挛越来越受欢迎，目前的文献表明其安全有效（A级）。限制诱导运动疗法（CIMT）和重复经颅磁刺激（rTMS）作为改善偏瘫 CP 运动功能的有效干预措施正在出现。然而，这些干预措施在减轻痉挛方面的作用仍有待阐明。
