Treatment of dystonic clenched fist with botulinum toxin

被引:77
作者
Cordivari, C
Misra, VP
Catania, S
Lees, AJ
机构
[1] UCL, Reta Lila Weston Inst Neurol Studies, London W1T 4JF, England
[2] Natl Hosp Neurol & Neurosurg, Dept Clin Neurophysiol, London WC1N 3BG, England
关键词
botulinum toxin; EMG; dystonic clenched fist; Parkinson's disease; corticobasal degeneration; dystonia associated with complex regional pain syndrome;
D O I
10.1002/mds.1186
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Fourteen patients with "dystonic clenched fist" (three with Corticobasal Ganglionic Degeneration, seven with Parkinson's disease, and four with Dystonic-Complex Regional Pain Syndrome) were treated with botulinum toxin A (BTXA, Dysport (R)). The muscles involved were identified by the hand posture and EMG activity recorded at rest and during active and passive flexion/extension movements of the finger and wrist. EMG was useful in distinguishing between muscle contraction and underlying contractures and to determine the dosage of BTX. All patients had some degree of flexion at the proximal metacarpophalangeal joints and required injections into the lumbricals. The response in patients depended on the severity of the deformity and the degree of contracture. All patients had significant benefit to pain, with accompanying muscle relaxation, and palmar infection, when present. was eradicated. Four patients With Parkinson's disease and one patient with Dystonia-Complex Regional Pain Syndrome obtained functional benefit. (C) 2001 Movement Disorder Society.
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页码:907 / 913
页数:7
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