针对性和顺序性冷神经溶解改善了在中风后性毒素不响应后的步态:一个实验室验证的病例
Frédéric Chantraine1, José Alexandre Pereira1, Céline Schreiber1
1RehaLAB, Centre National de Rééducation Fonctionnelle et de Réadaptation-Rehazenter, 1, Rue André Vésale, 2674 Luxembourg, Luxembourg.
Neurology international
|January 27, 2026
概括
低温神经溶解 (CNL) 为中风后性提供了持久的解决方案,改善了步态质量,并在不够注射肉毒素 (BTI) 时补充功能电刺激 (FES).
科学领域:
- 神经学 神经学
- 康复医学 康复医学 康复医学
- 医疗技术 医疗技术 医学技术
背景情况:
- 慢性脑卒中后性严重损害了步态,由于时间短暂和速移症等局限性,经常通过肉毒素肌内注射 (BTI) 进行不充分的管理.
- 低温神经溶解 (CNL) 提供了一种潜在的替代方案,用于持续降低音调,并具有较少的副作用,但其对整体步态的影响和与功能电刺激 (FES) 的协同作用需要进一步研究.
研究的目的:
- 评估超声导向冷神经溶解 (CNL) 在改善BTI耐药的慢性中风后性患者的步态质量的有效性.
- 评估CNL与植入功能电刺激 (FES) 系统的兼容性和协同效应.
主要方法:
- 一个案例研究涉及一个43岁的男性,患有慢性中风后性,接受了两次超声波引导的CNL治疗,准骨和股骨运动分支.
- 在CNL之前和之后,用FES和没有FES进行了定量步态分析和细线电肌图 (EMG),以评估性和步态参数.
- 毒素注射 (BTI) 之前只能提供暂时的益处.
主要成果:
- CNL导致三肌和四肌过度活动的立即和持续减少,解决性复发,并使刚硬的膝盖步态正常化.
- 在脚背曲,摇摆阶段膝盖曲,步态偏差指数 (69到80) 和吉列特步态指数 (下降了50%以上) 中观察到显著改善.
- 肌肉力量得到保留,在6个月的随访期间没有报告任何不良事件,CNL与FES协同作用.
结论:
- 针对外围运动神经的有针对性,顺序的CNL在慢性中风后性中提供安全和持久的步态改善,特别是当BTI达到其有效性上限时.
- CNL可以有效地与植入的FES相结合,以提高功能恢复.
- 定量步态分析和EMG是指导性管理决策的宝贵工具.
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