Dimitrijevic M R, Sherwood A M
Neurology. 1980 Jul;30(7 Pt 2):19-27. doi: 10.1212/wnl.30.7_part_2.19.
Electromyographic (EMG) recordings from multiple muscle groups with surface electrodes during systematic evaluation of phasic and tonic stretch reflexes, cutaneomuscular reflexes, long loop reflexes, postural reflexes, and volitional activation have been used to provide a neurophysiologic basis for selection of the appropriate treatment for spasticity, and to gain further insights into the general mechanisms of spasticity. Pharmacologic methods are useful as a temporary measure. Hypertonia of a single muscle can be effectively treated with 40% alcohol injections to the motor points and hypertonia of a muscle group with partial denervation through 6% phenol in water injected into the nerve trunk. Hypertonia of several muscle groups can be treated by chemical or surgical rhizotomy or myelotomy. Generalized hypertonia involving limb and trunk muscles can be modified through chronic epidural stimulation of the spinal cord. Modification of reciprocal antagonistic muscle activity may be achieved through electrical stimulation of the involved nerve trunks.
在对相位性和紧张性牵张反射、皮肤肌肉反射、长环反射、姿势反射和随意激活进行系统评估期间，使用表面电极对多个肌肉群进行肌电图（EMG）记录，已为选择合适的痉挛治疗方法提供了神经生理学依据，并进一步深入了解痉挛的一般机制。药物治疗方法作为一种临时措施很有用。单块肌肉的张力亢进可用40%酒精注射运动点有效治疗，部分失神经支配的肌肉群的张力亢进可通过向神经干注射6%水合酚来治疗。几块肌肉群的张力亢进可通过化学或外科脊髓后根切断术或脊髓切开术来治疗。涉及肢体和躯干肌肉的全身性张力亢进可通过慢性硬膜外脊髓刺激来改善。可通过对受累神经干进行电刺激来改变相互拮抗的肌肉活动。
