Silbert P L, Matsumoto J Y, McManis P G, Stolp-Smith K A, Elliott B A, McEvoy K M
Department of Neurology, Mayo Clinic, Rochester, MN 55904, USA.
Neurology. 1995 Oct;45(10):1893-7. doi: 10.1212/wnl.45.10.1893.
We performed a double-blind, placebo-controlled trial of intrathecal baclofen (ITB) in stiff-man syndrome. Three patients, unresponsive to current therapy, received 50 micrograms of ITB or placebo on sequential days. Following ITB, all patients demonstrated improvement in reflex EMG activity. The mean reduction in total EMG activity (from all muscles) following stimulation of the medial plantar nerve (cutaneous flexor reflex) was 72% following 50 micrograms of ITB compared with 18% following placebo (ANOVA: significance of F, p < 0.0001). The mean latency to onset of the response was also significantly prolonged for all muscles following ITB (ANOVA: significance of F, p < 0.05). Although reflex EMG activity was reduced in all patients, clinical improvement was evident in only one patient, who differed from the others studied by a longer duration of disease, greater severity of stiffness, less fear of falling, and greater electrophysiologic improvement.
我们开展了一项关于鞘内注射巴氯芬（ITB）治疗僵人综合征的双盲、安慰剂对照试验。三名对当前治疗无反应的患者在连续几天分别接受了50微克ITB或安慰剂治疗。注射ITB后，所有患者的反射性肌电图活动均有改善。刺激足底内侧神经（皮肤屈肌反射）后，50微克ITB治疗后所有肌肉总肌电图活动的平均降低幅度为72%，而安慰剂治疗后为18%（方差分析：F的显著性，p < 0.0001）。注射ITB后所有肌肉反应开始的平均潜伏期也显著延长（方差分析：F的显著性，p < 0.05）。虽然所有患者的反射性肌电图活动均降低，但仅一名患者有明显临床改善，该患者与其他研究对象的不同之处在于病程更长、僵硬程度更严重、跌倒恐惧更少以及电生理改善更大。
