Department of Neurology, St Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, D-44791 Bochum, Germany.
Ther Adv Neurol Disord. 2013 May;6(3):199-203. doi: 10.1177/1756285613475835.
Multiple sclerosis (MS)-related spasticity is associated with disability and impairment in quality of life. We report on a patient with secondary progressive MS and spastic tetraparesis (Expanded Disability Status Scale score 8.5). The right arm exhibited flexor spasticity resulting in functional disability despite multimodal symptomatic treatment. Intrathecal baclofen led to side effects despite decreasing efficacy. Low-dose nabiximols improved spasticity and function with recovery of daily-life activities and spasticity-related symptoms. Reduction of intrathecal baclofen ameliorated adverse drug reactions. Add-on cannabinoid therapy was effective in therapy-refractory spasticity with supra-additive effect in combining intrathecal baclofen and nabiximols, hypothetically explained by mutually complementing mechanisms of action.
多发性硬化症（MS）相关的痉挛与残疾和生活质量受损有关。我们报告了一例继发进展型 MS 伴痉挛性四肢瘫痪患者（扩展残疾状况量表评分 8.5）。右臂出现屈肌痉挛，尽管进行了多模式对症治疗，但仍导致功能障碍。尽管降低了疗效，但鞘内巴氯芬仍导致不良反应。低剂量纳比昔醇改善了痉挛和功能，恢复了日常生活活动和与痉挛相关的症状。减少鞘内巴氯芬可改善药物不良反应。在鞘内巴氯芬和纳比昔醇联合治疗中，附加的大麻素治疗对难治性痉挛有效，具有超相加效应，这可以用相互补充的作用机制来解释。
