Delwaide P J
Ann Neurol. 1985 Jan;17(1):90-5. doi: 10.1002/ana.410170119.
Variations in four electrophysiological tests (H/M, T/M, vibratory inhibition, and recovery curve of Hoffmann's reflex following stimulation at the ankle) were studied following a single administration of four myorelaxant drugs: diazepam (10 mg intramuscularly), baclofen (20 mg intramuscularly), tizanidine (4 mg orally), and idrocilamide (60 mg intramuscularly). Fifty-one spastic patients, divided into four groups, were tested. All four drugs reduced the H/M and T/M ratios very slightly. Only diazepam and tizanidine reinforced vibratory inhibition. Diazepam and tizanidine did not modify the abnormal recovery curves, however, whereas baclofen and idrocilamide did. Reinforcement of vibratory inhibition suggests an increase in presynaptic inhibition mediated by gamma-aminobutyric acid; changes in recovery curves are likely due to modifications of interneuronal reactivity. Matching myorelaxants to the predominant pathophysiological abnormality detected by electrophysiological exploration may lead to better treatment of spasticity.
在单次给予四种肌松药后，研究了四项电生理测试（H/M、T/M、振动抑制以及踝关节刺激后霍夫曼反射的恢复曲线）的变化情况。这四种肌松药分别为：地西泮（10mg肌肉注射）、巴氯芬（20mg肌肉注射）、替扎尼定（4mg口服）和伊多酰胺（60mg肌肉注射）。51名痉挛患者被分为四组进行测试。所有四种药物均使H/M和T/M比值略有降低。只有地西泮和替扎尼定增强了振动抑制。然而，地西泮和替扎尼定并未改变异常的恢复曲线，而巴氯芬和伊多酰胺则有此作用。振动抑制的增强表明由γ-氨基丁酸介导的突触前抑制增加；恢复曲线的变化可能是由于中间神经元反应性的改变。将肌松药与电生理检查检测到的主要病理生理异常相匹配，可能会更好地治疗痉挛。
