Castagna Anna, Albanese Alberto
IRCCS Fondazione Don Carlo Gnocchi (AC), Servizio di Analisi Funzione Locomotoria; Università Cattolica del Sacro Cuore (AA), Istituto di Neurologia; and IRCCS Istituto Clinico Humanitas (AA), Unità Operativa Neurologia, Rozzano, Milano.
Neurol Clin Pract. 2019 Feb;9(1):64-73. doi: 10.1212/CPJ.0000000000000568.
We provide a practical guide on the use of electromyography (EMG) and ultrasound (US) to assist botulinum neurotoxin (BoNT) treatment in patients with cervical dystonia (CD).
US and EMG guidance improve BoNT treatment in CD. Their use is particularly valuable for targeting deep neck muscles and managing complex cases. There is also evidence that adverse events are reduced when superficial or intermediate layer muscles are injected with assisted guidance.
A structured clinical approach, based on functional neck anatomy, guides CD assessment and BoNT treatment. Muscles are selected according to clinical, EMG and US findings. US provides anatomical visualization, while EMG complements by detecting muscle activity. We review here the current practice for assisted treatment of CD through BoNT cycles. We also describe how to recognize and manage the main adverse events.
我们提供一份关于使用肌电图（EMG）和超声（US）辅助治疗颈部肌张力障碍（CD）患者肉毒杆菌神经毒素（BoNT）的实用指南。
超声和肌电图引导可改善颈部肌张力障碍的肉毒杆菌神经毒素治疗。它们的使用对于靶向颈部深层肌肉和处理复杂病例特别有价值。也有证据表明，在辅助引导下注射浅层或中层肌肉时，不良事件会减少。
基于功能性颈部解剖结构的结构化临床方法可指导颈部肌张力障碍的评估和肉毒杆菌神经毒素治疗。根据临床、肌电图和超声检查结果选择肌肉。超声提供解剖可视化，而肌电图则通过检测肌肉活动起到补充作用。我们在此回顾通过肉毒杆菌神经毒素周期辅助治疗颈部肌张力障碍的当前实践。我们还描述了如何识别和处理主要不良事件。
