Richardson R R, Cerullo L J, Meyer P R
Neurosurgery. 1979 Jun;4(6):517-20. doi: 10.1227/00006123-197906000-00004.
Our clinical experience in the management of five paraplegic or quadriplegic patients with subjective complaints and objective findings of autonomic hyper-reflexia is presented. These five patients had epidural neurostimulation systems implanted percutaneously to regulate intractable spasticity. During a follow-up period varying from 2 months to almost 2 years, four of the five patients experienced no episodes of autonomic dysfunction with the use of a low frequency, low voltage, square wave pulse output. From their responses and from recent neurophysiological evidence, the potential benefit of percutaneous epidural neurostimulation in the modulation of autonomic hyper-reflexia without antihypertensive medication is suggested. Further follow-up of these patients and additional clinical research should be performed to confirm our initial clinical impressions.
本文介绍了我们对五例截瘫或四肢瘫患者的临床治疗经验，这些患者有自主神经反射亢进的主观症状和客观体征。这五例患者经皮植入了硬膜外神经刺激系统以调节难治性痉挛。在2个月至近2年的随访期内，五例患者中有四例在使用低频、低电压、方波脉冲输出时未出现自主神经功能障碍发作。根据他们的反应以及最近的神经生理学证据，提示经皮硬膜外神经刺激在无需使用抗高血压药物的情况下调节自主神经反射亢进方面具有潜在益处。应对这些患者进行进一步随访并开展更多临床研究，以证实我们最初的临床印象。
