Botulinum toxin in the treatment of tics
Botulinum toxin in the treatment of tics
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DOI：
10.1001/archneur.57.8.1190
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发表时间：
2000-08-01
影响因子：
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通讯作者：
Jankovic, J
中科院分区：
文献类型：
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作者：
Kwak, CH;Hanna, PH;Jankovic, J
目的：评价A型肉毒毒素（BTX）注射治疗Tourette综合征（TS）患者的安全性和有效性。背景：BTX是一种有效的治疗方法，用于治疗越来越多的以肌肉收缩异常为特征的疾病。BTX不仅可以改善运动的关系，但也预示着感觉之前ties.Methods：35例患者（30男，5女）与BTS治疗的网站，他们最有问题的关系。对BTX的反应基于0 - 4临床评定量表（0，无改善，至4，严重程度和功能均显著改善）。结果：平均持续时间的关系，首次注射前为15.3年（范围，1-62年），平均随访时间为21.2个月（范围，1.5-84个月）。在115次治疗中，35例患者的平均峰值效应反应为2.8（范围，0-4）;平均获益持续时间为14.4周（最长，45周），获益发生的平均潜伏期为3.8天（最长，10天）。25例有先兆感觉的患者中有21例（84%）症状明显缓解（平均获益70.6%）。总平均剂量为502.1 U（范围：15-3550 U）;平均访视次数为3.3（范围：1-16）;每次访视的平均剂量为119.9 U（范围：15-273 U）。注射部位如下：颈部或上胸部区域（17）、上面部（14）、下面部（7）、声带（dr）、上背部和/或肩部（3）、头皮（1）、前臂（1）、腿部（1）和腹直肌（1）。并发症包括颈部无力（4例）、吞咽困难（2例）、上睑下垂（2例）、恶心（1例）、发音减退（1例）、疲劳（1例）和全身无力（1例），这些并发症均为轻度和短暂的。除了改善领带的运动成分外，BTX还可以缓解先兆感觉。
Objective: To evaluate the safety and efficacy of botulinum toxin A (BTX) injections in the treatment of ties in patients with Tourette syndrome (TS).Background: BTX is an effective treatment for an increasing number of conditions characterized by abnormal muscle contractions. BTX may improve not only the motor component of ties, but also premonitory sensations that precede ties.Methods: Thirty-five patients (30 male, 5 female) were treated with BTS in the sites of their most problematic ties. Response to BTX was based on a 0 to 4 clinical rating scale (0, no improvement, to 4, marked improvement in both severity and function). Questionnaires were administered to evaluate patients' impressions of overall efficacy and degree of benefit with premonitory sensations.Results: Mean duration of ties prior to initial injection was 15.3 years (range, 1-62 years) and mean duration of follow-up was 21.2 months (range, 1.5-84 months). The mean peak effect response in 35 patients treated in 115 sessions was 2.8 (range, 0-4); the mean duration of benefit was 14.4 weeks (maximum, 45 weeks), and the mean latency to onset of benefit was 3.8 days (maximum, 10 days). Twenty-one (84%) of 25 patients with premonitory sensations derived marked relief of these symptoms (mean benefit, 70.6%). Total mean dose was 502.1 U (range, 15-3550 U); mean number of visits, 3.3 (range, 1-16); and mean dose per visit, 119.9 U (range, 15-273 U). Sites of injections were as follows: cervical or upper thoracic area (17), upper face (14), lower face (7), vocal cords (dr), upper back and/or shoulder (3), scalp (1), forearm (1), leg (1) and rectus abdominis (1). Complications included neck weakness (4), dysphagia (2), ptosis (2), nausea (1), hypophonia (1), fatigue (1), and generalized weakness (1), which were all mild and transient.Conclusions: Botulinum toxin A injections are an effective and well-tolerated treatment of ties. In addition to improving the motor component of ties, BTX also provides relief of premonitory sensations.