Delwaide P J
Recenti Prog Med. 1989 Dec;80(12):681-5.
Is characterized by several various signs. One of these, spasticity, involves a velocity dependent increase in muscle stiffness during stretch and by hyperactive tendon jerks. When intense, spasticity impedes residual strength in antagonistic muscles and interferes with attempts to move, especially if complicated by clonus and/or spasms. Assessment of spasticity is multifactorial and implies clinical as well as instrumental methods. The pathophysiological mechanisms responsive for the hyperexcitability of the myotatic reflex can be studied by methods of clinical neurophysiology. It appears that there are various factors involved at the spinal level, involving reduction in both pre- and post-synaptic inhibitions. Although spasticity is not responsible for the major part of the disability imposed by upper motor neurone syndrome, it should be reduced. The therapeutic methods are medical, surgical or from physical medicine. In many cases, the results have been validated by blind studies. As paresis is the most disabling effect, it would be worthwhile to develop drugs able to reduce spasticity and increase muscle strength at the same time. Recent trials suggest than TRH-T may be effective in this regard.
其特征表现为多种不同的体征。其中之一，痉挛，表现为在拉伸过程中肌肉僵硬随速度增加，且腱反射亢进。严重时，痉挛会妨碍拮抗肌的残余力量，并干扰运动尝试，尤其是当伴有阵挛和/或痉挛时。痉挛的评估是多因素的，涉及临床及器械检查方法。可通过临床神经生理学方法研究对肌伸张反射过度兴奋起作用的病理生理机制。似乎在脊髓水平有多种因素参与，包括突触前和突触后抑制的降低。尽管痉挛并非上运动神经元综合征所致残疾的主要原因，但仍应予以减轻。治疗方法包括药物、手术或物理医学方法。在许多情况下，结果已通过盲法研究得到验证。由于轻瘫是最具致残性的影响，研发能够同时减轻痉挛并增强肌肉力量的药物将是值得的。近期试验表明，TRH-T在这方面可能有效。
