Tolosa E S, Lai C
Neurology. 1979 Aug;29(8):1126-30. doi: 10.1212/wnl.29.8.1126.
A dopamine agonist (apomorphine) and a cholinomimetic drug (physostigmine) were administered to five patients with blepharospasm and oromandibular dystonia (Meige disease). The effects of haloperidol and levodopa were also assessed. Apomorphine lessened and physostigmine aggravated the facial dyskinesias in all patients, while placebo injections had no consistent effect. Levodopa did not modify the symptoms, but haloperidol attentuated the facial dystonia. Dysfunction of the basal ganglia, characterized by a state of striatal dopamine preponderance, probably underlies the dystonic spasms in Meige disease. The prominent cholinergic enhancement of facial dyskinesias may distinguish this disorder pharmacologically from tardive dyskinesia, a differentiation which has practical therapeutic implications.
给5例患有眼睑痉挛和口下颌肌张力障碍（梅杰氏病）的患者使用了多巴胺激动剂（阿扑吗啡）和拟胆碱药物（毒扁豆碱）。还评估了氟哌啶醇和左旋多巴的效果。阿扑吗啡减轻了所有患者的面部运动障碍，而毒扁豆碱则加重了面部运动障碍，而安慰剂注射没有一致的效果。左旋多巴没有改变症状，但氟哌啶醇减轻了面部肌张力障碍。以纹状体多巴胺优势状态为特征的基底神经节功能障碍可能是梅杰氏病肌张力障碍性痉挛的基础。面部运动障碍明显的胆碱能增强可能在药理学上使这种疾病与迟发性运动障碍区分开来，这种区分具有实际的治疗意义。
