Safarpour Yasaman, Jabbari Bahman
Division of Nephrology, Department of Medicine, University of California, Irvine, USA.
Division of Movement Disorders, Department of Neurology, Yale University School of Medicine, New Haven-CT, 31 Silver Pine Drive, Newport Coast, CA, 92657, USA.
Curr Treat Options Neurol. 2018 Feb 24;20(2):4. doi: 10.1007/s11940-018-0488-3.
Botulinum neurotoxins (BoNTs) are now among the most widely used therapeutic agents in clinical medicine with indications applied to the fields of movement disorders, pain disorders, and autonomic dysfunction. In this literature review, the efficacy and utility of BoNTs in the field of movement disorders are assessed using the criteria of the Guideline Development Subcommittee of the American Academy of Neurology. The literature supports a level A efficacy (established) for BoNT therapy in cervical dystonia and a level B efficacy (probably effective) for blepharospasm, hemifacial spasm, laryngeal dystonia (spasmodic dysphonia), task-specific dystonias, essential tremor, and Parkinson rest tremor. It is the view of movement disorder experts, however, that despite the level B efficacy, BoNTs should be considered treatment of first choice for blepharospasm, hemifacial spasm, laryngeal, and task-specific dystonias. The emerging data on motor and vocal tics of Tourette syndrome and oromandibular dystonias are encouraging but the current level of efficacy is U (undetermined) due to lack of published high-quality studies.
肉毒杆菌神经毒素（BoNTs）如今是临床医学中应用最为广泛的治疗药物之一，其适应症涵盖运动障碍、疼痛障碍和自主神经功能障碍等领域。在这篇文献综述中，依据美国神经病学学会指南制定小组委员会的标准，对BoNTs在运动障碍领域的疗效和效用进行了评估。文献支持BoNT治疗在颈部肌张力障碍方面具有A级疗效（已确立），在眼睑痉挛、半面痉挛、喉肌张力障碍（痉挛性发音障碍）、任务特异性肌张力障碍、特发性震颤和帕金森静止性震颤方面具有B级疗效（可能有效）。然而，运动障碍专家认为，尽管是B级疗效，但BoNTs仍应被视为眼睑痉挛、半面痉挛、喉部及任务特异性肌张力障碍的首选治疗方法。关于抽动秽语综合征的运动和发声抽动以及口下颌肌张力障碍的新数据令人鼓舞，但由于缺乏已发表的高质量研究，目前的疗效水平为U（未确定）。
