Wulff C H, Dupont E
Neurofysiologisk afdeling og neurologisk afdeling, Arhus Kommunehospital.
Ugeskr Laeger. 1993 Feb 1;155(5):284-9.
The effect of botulinum toxin A treatment was studied in patients with idiopathic torticollis. Twenty patients with idiopathic torticollis received electromyographically guided intramuscular botulinum toxin A into the hyperactive neck muscles. In all, 48 treatments were given. The injections were repeated with intervals of 11 to 35 weeks (mean 18.7 weeks). The grade of improvement was estimated subjectively using a visual analogue scale. An overall improvement of 55% compared with the status before treatment was found. The best result obtained in each individual patient varied from 20% to 84% (mean 66%). The effect of the treatment began to wear off after eight to 22 weeks (mean 11.5 weeks). The side effects consisted of short term dysphagia in two patients. The administration of botulinum toxin in idiopathic torticollis is a safe and beneficial treatment with few side effects. The EMG guidance of injections proved to be helpful as it restricted the injections into muscles with electromyographic hyperactivity, thereby economizing the amount of toxin given. It is doubtful if double-blind studies of botulinum toxin can be undertaken due to the marked muscular wasting and weakness caused by the injections.
对肉毒杆菌毒素A治疗特发性斜颈患者的效果进行了研究。20例特发性斜颈患者接受了肌电图引导下将肉毒杆菌毒素A注射到颈部活跃过度的肌肉中。总共进行了48次治疗。注射间隔为11至35周（平均18.7周）。采用视觉模拟量表主观评估改善程度。发现与治疗前状态相比总体改善率为55%。每个患者获得的最佳效果从20%至84%不等（平均66%）。治疗效果在8至22周（平均11.5周）后开始消退。副作用包括2例患者出现短期吞咽困难。肉毒杆菌毒素用于特发性斜颈的治疗是一种安全有益且副作用少的治疗方法。肌电图引导注射被证明是有帮助的，因为它将注射限制在肌电图活跃过度的肌肉中，从而节省了毒素用量。由于注射会导致明显的肌肉萎缩和无力，因此怀疑是否能进行肉毒杆菌毒素的双盲研究。
