Mayer N H, Esquenazi A, Childers M K
MossRehab Hospital, Philadelphia, PA 19141-3019, USA.
Muscle Nerve Suppl. 1997;6:S21-35.
An upper motor neuron syndrome often leads to the development of stereotypical patterns of deformity secondary to agonist muscle weakness, antagonist muscle spasticity and changes in the rheologic (stiffness) properties of spastic muscles. Identification of the spastic muscles that contribute to deformity across a joint allows therapeutic denervation to be implemented with the maximum likelihood of success. Identifying responsible muscles can be complex, since many muscles may cross the joint involved, and not all muscles with the potential to cause deformity will be spastic. Strategies including polyelectromyography and diagnostic blocks with local anesthetics can be used to test hypotheses regarding the deformity, providing information for more long-term denervation. In this review, we discuss frequently observed patterns of deformity associated with problematic spasticity, paresis, contracture, and impaired voluntary motor control.
上运动神经元综合征常导致继发于主动肌肌无力、拮抗肌痉挛以及痉挛肌肉流变学（僵硬）特性改变的典型畸形模式。识别导致关节畸形的痉挛肌肉，有助于最大程度提高治疗性去神经支配的成功率。确定责任肌肉可能很复杂，因为许多肌肉可能跨越受累关节，而且并非所有有导致畸形可能的肌肉都会发生痉挛。包括多电极肌电图和局部麻醉诊断性阻滞在内的策略，可用于检验有关畸形的假设，为更长期的去神经支配提供信息。在本综述中，我们讨论了与痉挛、轻瘫、挛缩和随意运动控制受损相关的常见畸形模式。
