van den Heuvel Corina N A M, Tijssen Marina A J, van de Warrenburg Bart P C, Delnooz Cathérine C S
Department of Neurology, Donders Institute for Brain, Cognition, and Behavior Radboud University Medical Center Nijmegen the Netherlands.
Department of Neurology University Medical Center Groningen Groningen the Netherlands.
Mov Disord Clin Pract. 2016 Aug 3;3(6):548-558. doi: 10.1002/mdc3.12400. eCollection 2016 Nov-Dec.
Acquired dystonia is caused by an acquired or exogenous event. Although the therapeutic armamentarium used in clinical practice is more or less similar to that used for inherited or idiopathic dystonia, formal proof of the efficacy of these interventions in acquired dystonia is lacking.
The authors attempt to provide a comprehensive and systematic review of the current evidence for medical and allied health care treatment strategies in acquired dystonias. The PubMed, Cochrane Library, MEDLINE, Web of Science, PiCarta, and PsycINFO databases were searched up to December 2015, including randomized controlled trials, patient-control studies, and case series or single case reports containing a report on clinical outcome.
There are level 3 practice recommendations for botulinum toxin injections and globus pallidus pars interna deep brain stimulation for tardive dystonia and dystonic cerebral palsy as well as intrathecal baclofen for dystonic cerebral palsy. There are insufficient and conflicting data on the effect (vs. the hazard) of other pharmacological interventions, and limited work has been done on other forms of neurostimulation and allied health care. Because no class A1 or A2 studies were identified, level 1 or 2 practice recommendations could not be deducted for a specific treatment intervention.
To improve the current medical and allied health care treatment options for patients with acquired dystonia, high-quality trials that examine the efficacy of therapies need to be performed.
后天性肌张力障碍由后天性或外源性事件引起。尽管临床实践中使用的治疗手段与用于遗传性或特发性肌张力障碍的手段或多或少相似，但缺乏这些干预措施在后天性肌张力障碍中疗效的正式证据。
作者试图对后天性肌张力障碍的医学及相关卫生保健治疗策略的现有证据进行全面系统的综述。检索了截至2015年12月的PubMed、Cochrane图书馆、MEDLINE、科学网、PiCarta和PsycINFO数据库，包括随机对照试验、患者对照研究以及包含临床结局报告的病例系列或单病例报告。
对于迟发性肌张力障碍和肌张力障碍型脑性瘫痪，肉毒毒素注射和苍白球内侧部脑深部刺激有3级实践推荐，对于肌张力障碍型脑性瘫痪，鞘内注射巴氯芬也有3级实践推荐。关于其他药物干预的效果（与风险相比）的数据不足且相互矛盾，关于其他形式的神经刺激和相关卫生保健的研究有限。由于未识别出A1或A2类研究，无法针对特定治疗干预得出1级或2级实践推荐。
为改善后天性肌张力障碍患者当前的医学及相关卫生保健治疗选择，需要开展高质量试验以检验治疗方法的疗效。
