Flachenecker Peter
Neurological Rehabilitation Center Quellenhof, Bad Wildbad, Germany.
Neurodegener Dis Manag. 2016 Dec;6(6s):9-12. doi: 10.2217/nmt-2016-0047.
In addition to muscle stiffness and increasing mobility restrictions, symptoms commonly associated with multiple sclerosis (MS) spasticity are spasms, sleep disturbances, pain, fatigue and bladder dysfunction. Treatment options include trigger factor avoidance, physiotherapy and antispasticity medication. Oral antispasticity agents commonly used in Germany are baclofen, tizanidine and gabapentin, but physician and patient satisfaction with their effectiveness is low. Over the past few years, randomized controlled trials, observational studies and registry data have demonstrated the positive risk:benefit profile of add-on 9-delta-tetra-hydrocannabinol:cannabidiol oromucosal spray for moderate-to-severe resistant MS spasticity. Herein, evidence for this novel therapeutic option is reviewed. A case study illustrates the level of improvement in daily functioning that is possible in treatment responders.
除了肌肉僵硬和活动受限加剧外，与多发性硬化症（MS）痉挛相关的常见症状还有痉挛、睡眠障碍、疼痛、疲劳和膀胱功能障碍。治疗选择包括避免触发因素、物理治疗和抗痉挛药物。德国常用的口服抗痉挛药物有巴氯芬、替扎尼定和加巴喷丁，但医生和患者对其疗效的满意度较低。在过去几年中，随机对照试验、观察性研究和登记数据表明，添加9-δ-四氢大麻酚：大麻二酚口腔黏膜喷雾剂治疗中度至重度难治性MS痉挛具有良好的风险效益比。本文对这一新型治疗选择的证据进行了综述。一个案例研究说明了治疗有反应者日常功能可能改善的程度。
