Jankovic J, Schwartz K
Department of Neurology, Baylor College of Medicine, Houston, TX 77030.
Neurology. 1990 Feb;40(2):277-80. doi: 10.1212/wnl.40.2.277.
We followed 205 of 232 patients with medically intractable cervical dystonia for at least 3 months and up to 4 years, during which time they received 1,074 injections in 505 visits. One hundred forty-five of the 205 patients (71%) improved substantially (global rating greater than or equal to 2; from 0 = no response to 4 = marked improvement in severity and function) after 1 or more visits. Of the 89 patients who reported pain, 68 (76%) had almost complete relief of their pain. While most patients noted improvement within the 1st week after injection, some had a latency of up to 8.5 weeks. Duration of maximum benefit lasted up to 12.5 months in some, but the average was 11.2 weeks. Only 58 of 205 (28%) patients, seen in 76 of 505 visits (15% of all visits), had complications, primarily mild dysphagia (35 patients) or neck weakness (17 patients). We conclude that botulinum toxin is a safe and effective therapy for most patients with cervical dystonia.
我们对232例药物难治性颈部肌张力障碍患者中的205例进行了至少3个月、最长4年的随访，在此期间，他们接受了505次就诊中的1074次注射。205例患者中有145例（71%）在1次或更多次就诊后有显著改善（整体评分大于或等于2；从0=无反应到4=严重程度和功能有明显改善）。报告有疼痛的89例患者中，68例（76%）的疼痛几乎完全缓解。虽然大多数患者在注射后第1周内就注意到有所改善，但有些患者的潜伏期长达8.5周。最大获益持续时间在一些患者中长达12.5个月，但平均为11.2周。205例患者中只有58例（28%）在505次就诊中的76次（占所有就诊的15%）出现并发症，主要是轻度吞咽困难（35例患者）或颈部无力（17例患者）。我们得出结论，肉毒杆菌毒素对大多数颈部肌张力障碍患者是一种安全有效的治疗方法。
