不寻常的延迟和长期的手臂软弱和缩后肉毒素注射为音乐家的:病例报告
Barbara I Karp1, Katharine Alter2, Tanya Lehky3
1Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, 20892, USA. karpb@ninds.nih.gov.
Journal of neural transmission (Vienna, Austria : 1996)
|February 17, 2025
概括
毒素注射用于焦点手 dystonia 很少会导致严重的,延迟的肌肉衰弱和缩. 这一案例突出了在接受长期治疗的音乐家中潜在的不良事件.
科学领域:
- 神经学 神经学
- 肌肉骨医学 肌肉骨医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 毒素是一种标准的第一线治疗方法,用于音乐家的焦点手 dystonia.
- 轻度,暂时的肌肉衰弱是注射肉毒素的已知副作用.
- 对于大多数患者来说,长期的疗效和安全性概况已经得到了很好的证实.
研究的目的:
- 报告一个独特的严重的病例,延迟发病的肌肉衰弱和缩后的毒素治疗音乐家的 dystonia.
- 提高临床医生对与肉毒素治疗相关的罕见但重大不良事件的认识.
主要方法:
- 一位钢琴家的案例报告,他有十年的历史,成功地用肉毒素治疗了焦点手 dystonia.
- 详细的临床观察开始,进展,和严重的软弱和肌肉缩的解决方案.
- 通过临床评估和实验室测试,排除诸如手臂神经炎,plexopathy和神经性肌缩等其他神经疾病.
主要成果:
- 一名患者在注射后六周出现了严重的,渐进的前臂软弱和缩,影响了注射和未注射的肌肉.
- 软弱和缩持续了一年多,在没有进一步干预的情况下自发消失.
- 与其他报告的病例不同,这名患者没有经历明显的疼痛,也没有显示出plexopathy或神经动脉缩的临床或实验室证据.
结论:
- 尽管毒素已被证实是安全的,但很少会导致严重,延迟和长期的肌肉衰弱和缩.
- 这种不良事件甚至可能发生在长期成功治疗和稳定剂量患者中.
- 临床医生必须保持警,寻找与肉毒素相关的罕见,严重的不良事件,即使没有典型的伴随症状,如疼痛或神经损伤迹象.
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