Davis D, Jabbari B
Department of Physical Medicine and Rehabilitation, Walter Reed Army Medical Center, Washington, DC.
Mov Disord. 1993 Jul;8(3):371-3. doi: 10.1002/mds.870080323.
Following several months of low back pain, a 36-year-old man developed progressive stiffness of the abdominal, low back, and thigh muscles. On examination, these muscles demonstrated marked hypertonia consistent with the clinical diagnosis of stiff-person syndrome. The patient demonstrated increased lumbar lordosis and had focal hyperhidrosis at different sites. Electromyography showed continuous activity of the paraspinal and thigh muscles, and serum and cerebrospinal fluid antibodies to glutamic acid decarboxylase (GAD) were markedly elevated. Diazepam and Lioresal offered partial pain relief. Paraspinal muscle administration of botulinum toxin A reduced the tone of paraspinal and thigh muscles significantly and resulted in marked improvement of ambulation and cessation of pain.
在经历了数月的下背痛后，一名36岁男性出现了腹部、下背部和大腿肌肉进行性僵硬。检查发现，这些肌肉表现出明显的张力亢进，符合僵人综合征的临床诊断。患者腰椎前凸增加，不同部位有局灶性多汗。肌电图显示椎旁肌和大腿肌肉持续活动，血清和脑脊液中谷氨酸脱羧酶（GAD）抗体显著升高。地西泮和氯苯氨丁酸可部分缓解疼痛。椎旁肌注射A型肉毒毒素可显著降低椎旁肌和大腿肌肉的张力，使步行明显改善且疼痛停止。
