通过向一块肌肉单次注射A型肉毒杆菌毒素治疗累及多块肌肉的局灶性肌张力障碍：一例报告。
Treatment of focal dystonia involving multiple muscles with a single injection of botulinum toxin A to 1 muscle: A case report.
作者信息
Lee Sung Young, Lee Hyeok Dong, Cho Young-Shin, Han Seung Hoon
机构信息
Department of Rehabilitation Medicine, Hanyang University College of Medicine, Seoul, Korea.
出版信息
Medicine (Baltimore). 2018 Oct;97(42):e12785. doi: 10.1097/MD.0000000000012785.
RATIONALE
Botulinum toxin A (BTX-A) injection is effective in treating focal dystonia. However, there are no prior reports regarding the treatment of progressive focal dystonia by a single BTX-A injection that affect a distant muscle.
PATIENT CONCERNS
A 19-year-old male was referred to the rehabilitation clinic with a complaint of involuntary movement in his left big toe. The involuntary movement pattern was initially observed in the abduction direction only; however, it progressed to irregular mixed patterns in the flexion and abduction directions.
DIAGNOSES
In needle electromyography, abnormal dystonic patterns were observed in the left abductor hallucis (AH), flexor hallucis longus, and flexor hallucis brevis muscles.
INTERVENTIONS AND OUTCOMES
These symptoms resolved with a single BTX-A injection to the AH muscle.
LESSONS
In this case, a single BTX-A injection to 1 muscle for treating progressive focal dystonia was effective on a distant noninjected muscle.
原理
A型肉毒毒素（BTX-A）注射在治疗局灶性肌张力障碍方面有效。然而，此前尚无关于单次BTX-A注射治疗影响远处肌肉的进行性局灶性肌张力障碍的报道。
患者情况
一名19岁男性因左大脚趾不自主运动而被转诊至康复诊所。不自主运动模式最初仅在外展方向观察到；然而，它发展为屈曲和外展方向的不规则混合模式。
诊断
在针极肌电图检查中，在左拇展肌（AH）、拇长屈肌和拇短屈肌中观察到异常的肌张力障碍模式。
干预措施及结果
对AH肌肉进行单次BTX-A注射后，这些症状得到缓解。
经验教训
在本病例中，对一块肌肉进行单次BTX-A注射以治疗进行性局灶性肌张力障碍，对远处未注射的肌肉有效。
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