Albanese Alberto, Abbruzzese Giovanni, Dressler Dirk, Duzynski Wojciech, Khatkova Svetlana, Marti Maria Jose, Mir Pablo, Montecucco Cesare, Moro Elena, Pinter Michaela, Relja Maja, Roze Emmanuel, Skogseid Inger Marie, Timerbaeva Sofiya, Tzoulis Charalampos
Neurologia I Istituto Neurologico Carlo Besta, Università Cattolica del Sacro Cuore, Via G. Celoria, 11, 20133, Milan, Italy.
Centre for Parkinson's Disease and Movement Disorders DINOGMI, University of Genoa Largo Daneo 3, 16132, Genoa, Italy.
J Neurol. 2015 Oct;262(10):2201-13. doi: 10.1007/s00415-015-7703-x. Epub 2015 Apr 1.
Cervical dystonia is a neurological movement disorder causing abnormal posture of the head. It may be accompanied by involuntary movements which are sometimes tremulous. The condition has marked effects on patients' self-image, and adversely affects quality of life, social relationships and employment. Botulinum neurotoxin (BoNT) is the treatment of choice for CD and its efficacy and safety have been extensively studied in clinical trials. However, current guidelines do not provide enough practical information for physicians who wish to use this valuable treatment in a real-life setting. In addition, patients and physicians may have different perceptions of what successful treatment outcomes should be. Consequently, an international group of expert neurologists, experienced in BoNT treatment, met to review the literature and pool their extensive clinical experience to give practical guidance about treatment of CD with BoNT. Eight topic headings were considered: the place of BoNT within CD treatment options; patient perspectives and desires for treatment; assessment and goal setting; starting treatment with BoNT-A; follow-up sessions; management of side effects; management of non-response; switching between different BoNT products. One rapporteur took responsibility for summarising the current literature for each topic, while the consensus statements were developed by the entire expert group. These statements are presented here along with a discussion of the background information.
颈部肌张力障碍是一种导致头部姿势异常的神经运动障碍。它可能伴有不自主运动，有时还会颤抖。这种疾病对患者的自我形象有显著影响，并对生活质量、社会关系和就业产生不利影响。肉毒杆菌神经毒素（BoNT）是颈部肌张力障碍的首选治疗方法，其疗效和安全性已在临床试验中得到广泛研究。然而，目前的指南并未为希望在实际临床环境中使用这种有效治疗方法的医生提供足够的实用信息。此外，患者和医生对于成功的治疗结果可能有不同的看法。因此，一组在肉毒杆菌毒素治疗方面经验丰富的国际神经科专家会面，回顾相关文献并汇集他们丰富的临床经验，以提供关于使用肉毒杆菌毒素治疗颈部肌张力障碍的实用指导。会议讨论了八个主题：肉毒杆菌毒素在颈部肌张力障碍治疗方案中的地位；患者对治疗的看法和期望；评估与目标设定；开始使用A型肉毒杆菌毒素治疗；随访；副作用管理；无反应的处理；不同肉毒杆菌毒素产品之间的转换。一位报告员负责总结每个主题的现有文献，而共识声明则由整个专家小组制定。以下将呈现这些声明以及对背景信息的讨论。
