Stöhr M, Heckl R
Arch Psychiatr Nervenkr (1970). 1977 Feb 23;223(2):171-80. doi: 10.1007/BF00345955.
Our electromyographical findings show no evidence for a spinal or neurogenic origin of muscle stiffness in stiff-man syndrome. It is assumed that the tonic muscle rigidity is induced by abnormal impulses from the brainstem. The measured latencies of electrically induced muscle spasm in the legs are in accordance with this hypothetic site of origin. Muscle stiffness and spasm are decreased by the GABA derivative Baclofen as well as by Clonacepam, which is preferable to Diazepam because of less intense sedation. Spasms are increased by Chlorimipramine which may by used as a provocative test in uncertain cases. These pharmacological influences suggest an imbalance between a gabaminergic inhibitory and a noradrenergic and/or serotoninergic excitatory neuronal system.
我们的肌电图检查结果显示,僵人综合征患者肌肉僵硬并非源于脊髓或神经源性。据推测,强直性肌肉僵硬是由脑干发出的异常冲动引起的。腿部电诱发肌肉痉挛的测量潜伏期与这一假设的起源部位相符。GABA衍生物巴氯芬以及氯硝西泮可减轻肌肉僵硬和痉挛,由于镇静作用较弱,氯硝西泮比地西泮更可取。氯米帕明可加剧痉挛,在诊断不明确的病例中可用作激发试验。这些药理作用表明,γ-氨基丁酸能抑制性神经元系统与去甲肾上腺素能和/或5-羟色胺能兴奋性神经元系统之间存在失衡。