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痉挛性肌张力障碍:仍然是一个有效的术语。

Spastic dystonia: Still a valid term.

机构信息

Complex Motor Disorders Service, Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Perinatal imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.

出版信息

Dev Med Child Neurol. 2023 Oct;65(10):1308-1315. doi: 10.1111/dmcn.15582. Epub 2023 Mar 20.

Abstract

Hypertonia in childhood may arise because of a variable combination of neuronal and non-neuronal factors. Involuntary muscle contraction may be due to spasticity or dystonia, which represent disorders of the spinal reflex arch and of central motor output respectively. Whilst consensus definitions for dystonia have been established, definitions of spasticity vary, highlighting the lack of a single unifying nomenclature in the field of clinical movement science. The term spastic dystonia refers to involuntary tonic muscle contraction in the context of an upper motor neuron (UMN) lesion. This review considers the utility of the term spastic dystonia, exploring our understanding of the pathophysiology of dystonia and the UMN syndrome. An argument is advanced that spastic dystonia is a valid construct that warrants further exploration. WHAT THIS PAPER ADDS: There is no single universally accepted definitions for terms commonly used to describe motor disorders. Spasticity and dystonia are phenomenologically and pathophysiologically distinct entities. Spastic dystonia represents a subset of dystonia, but with pathophysiological mechanisms more in common with spasticity.

摘要

儿童时期的张力亢进可能是由于神经元和非神经元因素的可变组合引起的。不随意肌收缩可能是由于痉挛或肌张力障碍引起的,它们分别代表脊髓反射弧和中枢运动输出的障碍。虽然已经为肌张力障碍建立了共识定义,但痉挛的定义各不相同,这突出表明在临床运动科学领域缺乏单一的统一命名法。术语痉挛性肌张力障碍是指在上运动神经元(UMN)损伤的情况下不随意的强直性肌肉收缩。这篇综述考虑了术语痉挛性肌张力障碍的实用性,探讨了我们对肌张力障碍的病理生理学和 UMN 综合征的理解。提出了一个论点,即痉挛性肌张力障碍是一个有效的构建,值得进一步探索。本文的贡献在于:没有一个普遍接受的定义可以用来描述运动障碍的术语。痉挛和肌张力障碍在表型和病理生理学上是不同的实体。痉挛性肌张力障碍是肌张力障碍的一个子集,但与痉挛的病理生理学机制更为相似。

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