Cosgrove A P, Corry I S, Graham H K
Department of Orthopaedic Surgery, Queen's University of Belfast, Northern Ireland.
Dev Med Child Neurol. 1994 May;36(5):386-96. doi: 10.1111/j.1469-8749.1994.tb11864.x.
The role of intramuscular botulinum toxin A in the treatment of 26 children with cerebral palsy was evaluated. The indication for injection was the presence of a dynamic contracture of lower-limb muscles interfering with positioning or walking. Spastic target muscles were identified by clinical examination and, in ambulant children, by gait analysis. Between 50 and 320 units of botulinum toxin were injected into each muscle group to a total dose of 100 to 400 units per child. The effects of injection were monitored by repeated clinical examination and gait analysis. There were no clinically detectable systemic side-effects, and all but one patient had a reduction in tone, which occurred within three days and persisted for two to four months. There were significant improvements in ambulatory status and in sagittal-plane kinematics. In some cases these gains persisted after the tone-reducing effects of the toxin had worn off.
评估了肌肉注射A型肉毒杆菌毒素对26例脑瘫患儿的治疗作用。注射的指征是存在干扰体位或行走的下肢肌肉动态挛缩。通过临床检查确定痉挛的目标肌肉，对于能行走的儿童，则通过步态分析来确定。每个肌肉组注射50至320单位的肉毒杆菌毒素，每名儿童的总剂量为100至400单位。通过反复的临床检查和步态分析监测注射效果。未发现临床上可检测到的全身副作用，除1例患者外，所有患者的肌张力均有所降低，这在三天内出现并持续两至四个月。行走状态和矢状面运动学有显著改善。在某些情况下，这些改善在毒素降低肌张力的作用消失后仍持续存在。
