Defining spasticity: a new approach considering current movement disorders terminology and botulinum toxin therapy
Defining spasticity: a new approach considering current movement disorders terminology and botulinum toxin therapy
复制标题
DOI：
10.1007/s00415-018-8759-1
复制
发表时间：
2018-04-01
影响因子：
6
通讯作者：
Saberi, Fereshte Adib
中科院分区：
文献类型：
--
作者：
Dressler, Dirk;Bhidayasiri, Roongroj;Saberi, Fereshte Adib
痉挛是发生在许多神经系统疾病中的症状，包括中风、多发性硬化、缺氧性脑损伤、创伤性脑损伤、肿瘤和遗传性退行性疾病。它会影响大量患者，并可能导致严重残疾。到目前为止，痉挛状态仅仅被描述为上运动神经元综合征的一部分，或者在狭义的神经生理学意义上被定义。由IAB跨学科运动障碍工作组组织的这一共识希望提供一个简短而实用的痉挛的新定义-第一次-基于当前运动障碍术语中描述的各种形式的肌肉过度活跃。我们提出了以下新的定义系统：痉挛描述不随意肌过度活动的中枢性轻瘫的存在。不随意肌多动可以由各种形式的肌肉多动组成：严格意义上的痉挛描述了由快速被动关节运动触发的不随意肌多动，由缓慢被动关节运动触发的僵硬不随意肌多动，肌张力障碍自发性不随意肌多动和通常由感觉或听觉刺激触发的痉挛复杂不随意运动。痉挛可以通过一个文件系统描述，该文件系统按照沿着临床表现（轴1）、病因（轴2）、局部（轴3）和其他中枢神经系统缺陷（轴4）分组。我们的新定义允许区分BT治疗可获得的痉挛成分和那些不可获得的痉挛成分。所提供的文档表为BT治疗计划提供了基本信息。
Spasticity is a symptom occurring in many neurological conditions including stroke, multiple sclerosis, hypoxic brain damage, traumatic brain injury, tumours and heredodegenerative diseases. It affects large numbers of patients and may cause major disability. So far, spasticity has merely been described as part of the upper motor neurone syndrome or defined in a narrowed neurophysiological sense. This consensus organised by IAB-Interdisciplinary Working Group Movement Disorders wants to provide a brief and practical new definition of spasticity-for the first time-based on its various forms of muscle hyperactivity as described in the current movement disorders terminology. We propose the following new definition system: Spasticity describes involuntary muscle hyperactivity in the presence of central paresis. The involuntary muscle hyperactivity can consist of various forms of muscle hyperactivity: spasticity sensu strictu describes involuntary muscle hyperactivity triggered by rapid passive joint movements, rigidity involuntary muscle hyperactivity triggered by slow passive joint movements, dystonia spontaneous involuntary muscle hyperactivity and spasms complex involuntary movements usually triggered by sensory or acoustic stimuli. Spasticity can be described by a documentation system grouped along clinical picture (axis 1), aetiology (axis 2), localisation (axis 3) and additional central nervous system deficits (axis 4). Our new definition allows distinction of spasticity components accessible to BT therapy and those inaccessible. The documentation sheet presented provides essential information for planning of BT therapy.