Botulinum toxin in writer's cramp: Objective response evaluation in 31 patients
Botulinum toxin in writer's cramp: Objective response evaluation in 31 patients
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DOI：
10.1136/jnnp.61.2.172
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发表时间：
1996-08-01
影响因子：
11
通讯作者：
Poewe, W
中科院分区：
文献类型：
--
作者：
Wissel, J;Kabus, C;Poewe, W
目的：为了量化局部注射肉毒杆菌毒素对书写痉挛的治疗效果，在31名接受肉毒杆菌毒素治疗的患者中使用了一种新开发的书写表现评定量表和一种计算机辅助的书写速度分析。（WCRS，见附录）和基于计算机的书写速度分析与随访期间记录的主观最佳反应时获得的结果进行比较。每次注射的平均剂量为133.2单位Dysport（R），分配在两块前臂肌肉之间。在平均随访一年的所有124次注射中，76%的注射效果良好。最常见的副作用是虚弱（72%的随访访视）。由四名独立评分者通过盲法录像审查评估的WCRS评分显示评分者之间具有良好的可靠性，并且治疗后有显着改善（P < 0.001）。笔移动的速度显示出显著的（P < 0.05）治疗后主观最佳效果记录增加，并与WCRS分项评分显著相关，记录量表的有效性。结论-本研究是第一个显示肉毒杆菌毒素治疗对书写痉挛患者的显著效果的研究，其基础是一个与书写显著相关的书写表现的量化量表速度测量因此，在本研究中采用的WCRS可能被证明是一个有用的评级工具，在其他研究中评估严重程度和治疗反应的患者书写痉挛。
Objectives-To quantify the treatment effect of local botulinum toxin injections in writer's cramp a newly developed rating scale of writing performance and a computer assisted analysis of writing speed were used in 31 patients undergoing botulinum toxin therapy.Methods-Baseline data of the writer's cramp rating scale (WCRS, see appendix) and computer based writing speed analysis were compared with those obtained at the time of subjective best response as recorded during follow up visits.Results-The mean dose injected to per session was 133.2 units Dysport(R) divided between two forearm muscles. Of all 124 injection sessions during mean follow up of one year 76% produced a good improvement. The most common side effect was weakness (72% of the follow up visits). The WCRS scores as assessed by a blinded videotape review by four independent raters showed good reliability between raters and a significant improvement after treatment (P < 0.001). The speed of pen movements showed a significant (P < 0.05) increase after treatment at subjective best effect recordings and a significant correlation with WCRS subscores, documenting the validity of the scale.Conclusion-The present study is the first to show significant effects of botulinum toxin treatment in patients with writer's cramp on the basis of a quantifiable scale for writing performance which correlates significantly with writing speed measurements. The WCRS as employed in this study might therefore prove a useful rating instrument in other studies assessing severity and treatment response in patients with writer's cramp.