Servelhere Katiane R, Faber Ingrid, Martinez Alberto, Nickel Renato, Moro Adriana, Germiniani Francisco M B, Moscovich Mariana, Blume Tatiane R, Munhoz Renato P, Teive Hélio A G, França Marcondes C
Departamento de Neurologia, Hospital de Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
Departamento de Medicina Interna, Serviço de Neurologia, Unidade de Distúrbios do Movimento, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brasil.
Arq Neuropsiquiatr. 2018 Mar;76(3):183-188. doi: 10.1590/0004-282x20180013.
Motor and non-motor manifestations are common and disabling features of hereditary spastic paraplegia (HSP). Botulinum toxin type A (Btx-A) is considered effective for spasticity and may improve gait in these patients. Little is known about the effects of Btx-A on non-motor symptoms in HSP patients. Objective To assess the efficacy of Btx-A on motor and non-motor manifestations in HSP patients. Methods Thirty-three adult patients with a clinical and molecular diagnosis of HSP were evaluated before and after Btx-A injections. Results Mean age was 41.7 ± 13.6 years and there were 18 women. Most patients had a pure phenotype and SPG4 was the most frequent genotype. The Btx-A injections resulted in a decrease in spasticity at the adductor muscles, and no other motor measure was significantly modified. In contrast, fatigue scores were significantly reduced after Btx-A injections. Conclusion Btx-A injections resulted in no significant functional motor improvement for HSP, but fatigue improved after treatment.
运动和非运动表现是遗传性痉挛性截瘫（HSP）常见且致残的特征。A型肉毒毒素（Btx-A）被认为对痉挛有效，可能改善这些患者的步态。关于Btx-A对HSP患者非运动症状的影响知之甚少。目的评估Btx-A对HSP患者运动和非运动表现的疗效。方法对33例临床和分子诊断为HSP的成年患者在注射Btx-A前后进行评估。结果平均年龄为41.7±13.6岁，女性18例。大多数患者为单纯型表型，SPG4是最常见的基因型。Btx-A注射使内收肌痉挛减轻，其他运动指标无明显改变。相比之下，Btx-A注射后疲劳评分显著降低。结论Btx-A注射对HSP患者的运动功能无显著改善，但治疗后疲劳有所改善。
