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BENEFIT AND SAFETY OF INCOBOTULINUMTOXINA FOR EARLY MANAGEMENT OF POST-STROKE SPASTICITY IN A PATIENT WITH SARS-COV-2: A CASE REPORT.因新型冠状病毒肺炎患者中风后痉挛早期管理使用A型肉毒毒素的获益与安全性:一例病例报告
J Rehabil Med Clin Commun. 2021 Jun 14;4:1000065. doi: 10.2340/20030711-1000065. eCollection 2021.
2
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J Neurol Sci. 2015 Oct 15;357(1-2):192-7. doi: 10.1016/j.jns.2015.07.028. Epub 2015 Jul 21.
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Neuronox versus BOTOX in the Treatment of Post-Stroke Upper Limb Spasticity: A Multicenter Randomized Controlled Trial.Neuronox与保妥适治疗中风后上肢痉挛:一项多中心随机对照试验
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Safety and efficacy of letibotulinumtoxinA(BOTULAX®) in treatment of post stroke upper limb spasticity: a randomized, double blind, multi-center, phase III clinical trial.注射用利鲁唑治疗肌萎缩侧索硬化的随机、双盲、多中心、III 期临床研究。
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J Neurol Sci. 2017 Jul 15;378:182-186. doi: 10.1016/j.jns.2017.04.052. Epub 2017 May 1.
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Can botulinum toxin type A injection technique influence the clinical outcome of patients with post-stroke upper limb spasticity? A randomized controlled trial comparing manual needle placement and ultrasound-guided injection techniques.A型肉毒毒素注射技术会影响中风后上肢痉挛患者的临床疗效吗?一项比较手工进针法与超声引导注射技术的随机对照试验。
J Neurol Sci. 2014 Dec 15;347(1-2):39-43. doi: 10.1016/j.jns.2014.09.016. Epub 2014 Sep 19.
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本文引用的文献

1
Added-value of spasticity reduction to improve arm-hand skill performance in sub-acute stroke patients with a moderately to severely affected arm-hand.降低痉挛对改善中重度手臂功能障碍的亚急性中风患者的手臂手部技能表现的附加价值。
NeuroRehabilitation. 2021;48(3):321-336. doi: 10.3233/NRE-201622.
2
Discontinuation of botulinum neurotoxin type-A treatment during COVID-19 pandemic: an Italian survey in post stroke and traumatic brain injury patients living with spasticity.COVID-19 大流行期间停止使用肉毒毒素 A 治疗:意大利一项针对伴有痉挛的脑卒中及创伤性脑损伤患者的调查。
Eur J Phys Rehabil Med. 2021 Jun;57(3):424-433. doi: 10.23736/S1973-9087.20.06478-3. Epub 2020 Dec 2.
3
Sustained efficacy of incobotulinumtoxina repeated injections for upper-limb post-stroke spasticity: A post hoc analysis.重复注射依库珠单抗治疗脑卒中后上肢痉挛的持续疗效:一项事后分析。
J Rehabil Med. 2021 Jan 5;53(1):jrm00138. doi: 10.2340/16501977-2760.
4
Botulinum toxin therapy in the SARS-CoV-2 pandemic: patient perceptions from a German cohort.在 SARS-CoV-2 大流行期间使用肉毒杆菌毒素治疗:来自德国队列的患者看法。
J Neural Transm (Vienna). 2020 Sep;127(9):1271-1274. doi: 10.1007/s00702-020-02235-6. Epub 2020 Jul 30.
5
Spasticity Treatment During COVID-19 Pandemic: Clinical Recommendations.2019冠状病毒病大流行期间的痉挛治疗:临床建议
Front Neurol. 2020 Jun 23;11:719. doi: 10.3389/fneur.2020.00719. eCollection 2020.
6
Long-Term Efficacy of Ultrasound-Guided Injection of IncobotulinumtoxinA in Piriformis Syndrome.超声引导下注射英科博肉毒素A治疗梨状肌综合征的长期疗效
Pain Med. 2018 Feb 1;19(2):408-411. doi: 10.1093/pm/pnx135.
7
Safety and efficacy of incobotulinumtoxinA doses up to 800 U in limb spasticity: The TOWER study.用于肢体痉挛的高达800单位的因卡波糖毒素A剂量的安全性和有效性:TOWER研究。
Neurology. 2017 Apr 4;88(14):1321-1328. doi: 10.1212/WNL.0000000000003789. Epub 2017 Mar 10.
8
Safety and efficacy of incobotulinumtoxinA as a potential treatment for poststroke spasticity.incobotulinumtoxinA作为中风后痉挛潜在治疗方法的安全性和有效性。
Neuropsychiatr Dis Treat. 2016 Jan 27;12:251-63. doi: 10.2147/NDT.S86978. eCollection 2016.
9
Spasticity after stroke: physiology, assessment and treatment.中风后的痉挛:生理学、评估与治疗
Brain Inj. 2013;27(10):1093-105. doi: 10.3109/02699052.2013.804202. Epub 2013 Jul 25.
10
Safety and efficacy of incobotulinum toxin type A (NT 201-Xeomin) for the treatment of post-stroke lower limb spasticity: a prospective open-label study.采用新型肉毒毒素(NT 201-Xeomin)治疗脑卒中后下肢痉挛的安全性和有效性:一项前瞻性开放标签研究。
Eur J Phys Rehabil Med. 2013 Aug;49(4):483-9. Epub 2013 Mar 13.

因新型冠状病毒肺炎患者中风后痉挛早期管理使用A型肉毒毒素的获益与安全性:一例病例报告

BENEFIT AND SAFETY OF INCOBOTULINUMTOXINA FOR EARLY MANAGEMENT OF POST-STROKE SPASTICITY IN A PATIENT WITH SARS-COV-2: A CASE REPORT.

作者信息

Cordero-GarcÍa Carlos, SÁEnz De Tejada SÁnchez María Del Mar

机构信息

Department of Physical Medicine and Rehabilitation, Juan Ramón Jiménez University Hospital, Huelva, Spain.

出版信息

J Rehabil Med Clin Commun. 2021 Jun 14;4:1000065. doi: 10.2340/20030711-1000065. eCollection 2021.

DOI:10.2340/20030711-1000065
PMID:34276907
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8215229/
Abstract

OBJECTIVE

To describe a case of early management of post-stroke spasticity treated with incobotulinumtoxinA (IncoA) in a patient with SARS-CoV-2 (COVID-19). Scarce information is available on this subject, as the COVID-19 pandemic has necessitated postponement of interventions in infected and clinically suspicious patients.

CASE REPORT

A 58-year-old woman presenting with ischaemic stroke, was infected with SARS-CoV-2 virus due to nosocomial contact. Despite clinical improvement, the patient developed early spasticity. Modified Ashworth Scale (MAS) was grade II in her left elbow, wrist flexors and left gastrocnemius. IncoA was injected, using ultrasound guidance, in her upper and lower limbs. No complications were reported after the procedure. Two weeks afterwards, there was an improvement in her motor balance and spasticity, MAS was graded I in the left elbow, wrist flexors, and II in the left gastrocnemius. At 12 weeks, the patient reported improvement at a global level, with increasing independence and functionality.

CONCLUSION

This case indicates the benefits and safety of IncoA for early treatment of post-stroke spasticity in a patient with confirmed SARS-CoV-2. Despite the current status of national healthcare systems due to the COVID-19 pandemic, increased efforts should be made to avoid discontinuation of treatment for spasticity.

摘要

目的

描述1例感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2,即新型冠状病毒肺炎)患者使用incobotulinumtoxinA(IncoA)对中风后痉挛进行早期治疗的病例。关于这一主题的信息很少,因为新型冠状病毒肺炎大流行使得对感染及临床疑似患者的干预措施不得不推迟。

病例报告

一名58岁女性因缺血性中风入院,因医院感染接触感染了SARS-CoV-2病毒。尽管临床症状有所改善,但患者出现了早期痉挛。改良Ashworth量表(MAS)显示其左肘部、腕屈肌和左腓肠肌为II级。在超声引导下对其上肢和下肢注射了IncoA。术后未报告并发症。两周后,其运动平衡和痉挛情况有所改善,左肘部、腕屈肌的MAS分级为I级,左腓肠肌为II级。12周时,患者报告整体情况有所改善,独立性和功能有所增强。

结论

本病例表明IncoA对确诊感染SARS-CoV-2的患者早期治疗中风后痉挛具有益处且安全。尽管由于新型冠状病毒肺炎大流行,国家医疗系统目前处于这种状况,但仍应加大力度避免中断对痉挛的治疗。