From the Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Am J Phys Med Rehabil. 2018 Jun;97(6):e51-e54. doi: 10.1097/PHM.0000000000000763.
Cervical dystonia is a common issue in patients with athetoid cerebral palsy. Botulinum toxin injection to dystonic cervical muscles is a well-recognized treatment option, but it is known to be associated with dysphagia. Previously reported cases of dysphagia after botulinum toxin injection to the sternocleidomastoid muscle were related to the regional spread of toxin to the pharyngeal muscles. We report a unique case of posture-dependent dysphagia due to preactivation of the suprahyoid and infrahyoid muscles to compensate for impaired head stabilization by the weakened sternocleidomastoid muscle while swallowing. This case suggests a possible mechanism of dysphagia in patients with athetoid cerebral palsy.
痉挛性斜颈是手足徐动型脑瘫患者常见的问题。肉毒毒素注射至痉挛性颈肌是一种公认的治疗选择，但已知与吞咽困难有关。先前报道的肉毒毒素注射至胸锁乳突肌后出现吞咽困难的病例与毒素向咽肌的区域性扩散有关。我们报告了一例因颏舌骨肌和舌骨下肌预先激活以代偿因胸锁乳突肌无力导致的头部稳定受损而导致的姿势依赖性吞咽困难的独特病例。吞咽时。该病例提示了手足徐动型脑瘫患者吞咽困难的可能机制。
