Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara 06100, Turkey.
Ankara Physical Medicine and Rehabilitation Training and Research Center, Ankara 06100, Turkey.
Toxins (Basel). 2018 Sep 28;10(10):396. doi: 10.3390/toxins10100396.
Recently, the importance of targeting structures during botulinum neurotoxin applications has been discussed in a variety of disorders, including spasticity and dystonia. In this respect, the advantages of ultrasound imaging to traditional techniques have been emphasized. We would like underscore the importance of ultrasound guidance, with targeting innervation zone(s) of the over-active muscles to achieve effective clinical outcomes. Additionally, we also clarify the difference between the terms-innervation zone (motor end plate) and motor point-which have been used by the authors as if they were the same. Further, we disagree with the authors about the intramuscular botulinum neurotoxin application techniques i.e., in-plane vs. out-of-plane whereby the former is, for sure, superior.
最近，在多种疾病中，包括痉挛和肌张力障碍，针对肉毒毒素应用中的结构进行靶向治疗的重要性已经得到了讨论。在这方面，超声成像相对于传统技术的优势已经被强调。我们要强调超声引导的重要性，通过靶向过度活跃肌肉的神经支配区，以实现有效的临床效果。此外，我们还澄清了术语-神经支配区（运动终板）和运动点-之间的区别，作者似乎将它们视为相同的概念。此外，我们不同意作者关于肉毒毒素在肌肉内应用技术的观点，即平面内与平面外，前者肯定更优越。
