Park So-Hyun, Shin Joon-Ho
Department of Rehabilitation Medicine, National Rehabilitation Center, Ministry of Health and Welfare, Seoul, Korea.
Translational Research Center for Rehabilitation Robots, National Rehabilitation Center, Ministry of Health and Welfare, Seoul, Korea.
Ann Rehabil Med. 2024 Dec;48(6):396-404. doi: 10.5535/arm.240065. Epub 2024 Dec 16.
Tremors are caused by contractions of reciprocally innervated muscles. The role of ultrasound in diagnosing tremors has not yet been investigated, although it appears to be promising because it can visualize muscle movements. In the present study, we report four cases of tremor (Holmes' tremor, extremity tremor associated with palatal myoclonus, dystonic tremor, and tremor associated with dystonia), which were evaluated using ultrasound and treated with botulinum toxin injections.
The muscles of patients with tremors were examined using B- or M-mode ultrasound while they were in the supine position. Tremor was determined by involuntary muscular contraction (B-mode) or fasciculation (M-mode) from recorded sonography clips. Thereafter, tremors were measured as frequency and amplitude of specific muscles. Ultrasound-guided botulinum toxin type A injection was administered, and follow-up ultrasonography was used to assess tremors.
Tremors, which manifest as a specific set of muscle contractions, were measured using ultrasonography and treated with botulinum toxin injection. Follow-up ultrasonography revealed improved tremors as seen with decreased frequency and amplitude of specific muscle after the intervention, which included medication and botulinum toxin injections.
Ultrasonography is an effective assessment tool for tremors, allowing further information regarding tremor characteristics with high sensitivity, playing a role in detecting specific muscles that are affected by tremors, and guiding an exact intervention with botulinum toxin.
震颤由相互支配的肌肉收缩引起。超声在震颤诊断中的作用尚未得到研究，尽管它似乎很有前景，因为它可以可视化肌肉运动。在本研究中，我们报告了4例震颤病例（霍姆斯震颤、与腭肌阵挛相关的肢体震颤、肌张力障碍性震颤以及与肌张力障碍相关的震颤），这些病例均接受了超声评估并接受了肉毒毒素注射治疗。
让震颤患者仰卧位，使用B型或M型超声检查其肌肉。通过记录的超声图像片段中的非自愿肌肉收缩（B型）或肌束震颤（M型）来确定震颤。此后，测量特定肌肉的震颤频率和幅度。进行超声引导下A型肉毒毒素注射，并使用超声随访评估震颤情况。
通过超声测量出表现为特定一组肌肉收缩的震颤，并采用肉毒毒素注射进行治疗。随访超声检查显示，在包括药物治疗和肉毒毒素注射在内的干预后，特定肌肉的频率和幅度降低，震颤得到改善。
超声检查是一种有效的震颤评估工具，能够以高灵敏度提供有关震颤特征的更多信息，在检测受震颤影响的特定肌肉以及指导肉毒毒素的精确干预方面发挥作用。
