Kheder Ammar, Nair Krishnan Padmakumari Sivaraman
Department of Neurology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield, UK.
Pract Neurol. 2012 Oct;12(5):289-98. doi: 10.1136/practneurol-2011-000155.
Spasticity is common in many neurological disorders, such as stroke and multiple sclerosis. It is part of the upper motor neurone syndrome manifesting as increased tone, clonus, spasms, spastic dystonia and co-contractions. The impact of spasticity varies from it being a subtle neurological sign to severe spasticity causing pain and contractures. Existing spasticity can be worsened by external factors such as constipation, urinary tract infections or pressure ulcers. Its management involves identification and elimination of triggers; neurophysiotherapy; oral medications such as baclofen, tizanidine and dantrolene; focal injection of botulinum toxin, alcohol or phenol, or baclofen delivered intrathecally through a pump; and surgical resection of selected dorsal roots of the spinal cord. This article reviews the current understanding of pathophysiology, clinical features and management of spasticity.
痉挛在许多神经系统疾病中很常见，如中风和多发性硬化症。它是上运动神经元综合征的一部分，表现为肌张力增加、阵挛、痉挛、痉挛性肌张力障碍和共同收缩。痉挛的影响各不相同，从轻微的神经体征到导致疼痛和挛缩的严重痉挛。现有的痉挛可能会因便秘、尿路感染或压疮等外部因素而加重。其治疗包括识别和消除诱因；神经物理治疗；口服药物，如巴氯芬、替扎尼定和丹曲林；局部注射肉毒杆菌毒素、酒精或苯酚，或通过泵鞘内注射巴氯芬；以及手术切除脊髓选定的背根。本文综述了目前对痉挛的病理生理学、临床特征和治疗的认识。
