Thal L J, Sharpless N S, Wolfson L, Katzman R
Ann Neurol. 1980 Jun;7(6):570-6. doi: 10.1002/ana.410070611.
Six patients with myoclonus of varying cause were treated with L-5-hydroxytryptophan (L-5-HTP) and carbidopa. While spontaneous myoclonus decreased in three of the patients and action myoclonus in four, only two patients had marked functional improvement. Side effects included gastrointestinal and affective disturbances. L-5-HTP therapy caused a diminished frequency of paroxysmal discharges in the electroencephalograms of three patients which did not always correlate with clinical improvement. Lumbar cerebrospinal fluid 5-hydroxyindoleacetic acid (5-HIAA) concentration after probenecid was decreased in all patients prior to therapy, but this reduction did not predict treatment response. Urinary excretion patterns for 5-HTP, serotonin, and 5-HIAA during treatment were similar in responders and nonresponders. It is concluded that while some patients with myoclonus do benefit from L-5-HTP therapy, biochemical and electrophysiological tests are not useful predictors of treatment response, and the high incidence of side effects limits the usefulness of this therapy.
六名病因各异的肌阵挛患者接受了L-5-羟色氨酸（L-5-HTP）和卡比多巴治疗。虽然三名患者的自发性肌阵挛减少，四名患者的动作性肌阵挛减少，但只有两名患者有明显的功能改善。副作用包括胃肠道和情感障碍。L-5-HTP治疗使三名患者的脑电图中阵发性放电频率降低，但这并不总是与临床改善相关。在治疗前，所有患者服用丙磺舒后的腰椎脑脊液5-羟吲哚乙酸（5-HIAA）浓度均降低，但这种降低并不能预测治疗反应。治疗期间，反应者和无反应者的5-HTP、血清素和5-HIAA的尿排泄模式相似。结论是，虽然一些肌阵挛患者确实从L-5-HTP治疗中获益，但生化和电生理测试并非治疗反应的有用预测指标，且副作用发生率高限制了该疗法的实用性。
