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A型肉毒杆菌毒素治疗肌萎缩侧索硬化症下肢痉挛:两例报告

Botulinum toxin type A for amyotrophic lateral sclerosis lower limb spasm: two case reports.

作者信息

Duan Qiang, Li Chao, Wei Chunxia, Wang Qian, Wang Bo, Sun Liangwen, He Yongjing, Qin Junxia, Huang Xiaoqun

机构信息

Department of Rehabilitation Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, 443000, China.

Department of Neurology, The First College of Clinical Medical Science, China Three Gorges Universityï¿¿Yichang Central People's Hospital, Yichang, China.

出版信息

BMC Neurol. 2025 Jul 1;25(1):263. doi: 10.1186/s12883-025-04266-6.

Abstract

BACKGROUND

Patients with amyotrophic lateral sclerosis (ALS) often experience spasticity, which can severely affect their ability to perform basic activities like standing and walking, potentially diminishing their already compromised quality of life. Botulinum toxin type A (BTX-A) is a first-line drug for spastic management. However, there are limited reports on its effectiveness in reducing muscle tone among ALS patients, with scarcely any related research conducted in China. We conducted the clinical observation and follow-up study through the relevant ethical post (ChiCTR2200061794). Clinical registration was on July 2, 2022. All participants provided written informed consent.

CASE PRESENTATION

We report two cases of middle-aged male patients, both diagnosed with ALS, who presented with symptoms such as limb stiffness and walking limitation due to increased muscle tone in the lower limbs. Based on the spasticity of the patient's lower limbs, the corresponding target muscles were selected for BTX-A treatment under ultrasound guidance, and the patients were evaluated on relevant functional scales before injection (baseline, T0) and at three follow-up visits (T1: 2 weeks, T2: 4 weeks, T3: 8 weeks).

CONCLUSION

Appropriate BTX-A injected into the target muscles could effectively depress the spasticity of ALS patients without apparent side effects.

摘要

背景

肌萎缩侧索硬化症(ALS)患者常出现痉挛,这会严重影响他们进行站立和行走等基本活动的能力,可能会降低他们本已受损的生活质量。A型肉毒毒素(BTX-A)是治疗痉挛的一线药物。然而,关于其在降低ALS患者肌张力方面有效性的报道有限,在中国几乎没有相关研究。我们通过相关伦理审查(ChiCTR2200061794)进行了临床观察和随访研究。临床注册于2022年7月2日进行。所有参与者均提供了书面知情同意书。

病例报告

我们报告两例中年男性患者,均诊断为ALS,因下肢肌张力增加出现肢体僵硬和行走受限等症状。根据患者下肢的痉挛情况,在超声引导下选择相应的靶肌肉进行BTX-A治疗,并在注射前(基线,T0)和三次随访(T1:2周,T2:4周,T3:8周)时对患者进行相关功能量表评估。

结论

向靶肌肉注射适当剂量的BTX-A可有效降低ALS患者的痉挛程度,且无明显副作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bbf/12210711/87796829ea56/12883_2025_4266_Fig1_HTML.jpg

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