文摘
摘要目的:调查两个目标技术onabotulinum毒素(肉毒毒素)注射治疗焦点手肌张力障碍和上肢痉挛状态:电生理学的指导使用电刺激(E-stim)和超声(美国)。
背景:肉毒毒素注射治疗是有效治疗焦点建立上肢痉挛状态,通常用于上肢肌张力障碍。肉毒毒素注射肢体可能执行使用解剖地标,EMG、E-stim和美国指导。数量有限的研究试图比较这些注入指导技术与不确定的结果。
设计/方法:两个中心,随机,交叉,assessor-blinded审判。焦的手肌张力障碍患者或上肢痉挛状态,在稳定之前至少2注射肉毒毒素治疗周期,被录取。病人被随机分为E-stim或我们。手术结束时的不适过程和有效性/不利影响在一个月后进行评估的过程。在第一次手术后3个月,病人跨越到其他的指导方法,具有类似重复评估。重复措施ANCOVA是使用线性混合模型协变量的选择。
结果:20名受试者中,12个男性,10上肢痉挛及肌张力障碍。没有区别两种定位技术在注射后利益或弱点,以两个patient-reported视觉模拟量表(血管,0 - 100,最小二乘法与E-stim平均51.5毫米,53.1)或临床医生全球变化(CGI)的印象。被认为不适有显著差异,E-stim视为更不舒服的病人,脉管LS平均34.5 vs 19.9 E-stim和美国,分别(p = 0.0082)。没有严重不良事件。
结论:E-stim和美国指导程序产生类似的好处和软弱。E-stim患者被认为更不舒服。额外的分析,包括每个指导方法过程持续时间的影响,肌肉无力和有效性之间的相关性,和子群分析的条件,正在进行。
披露:亚历山德拉Nmashie没有披露。Lungu博士已经收到个人薪酬在10000 - 49999美元的范围作为一个编辑,副主编,或编辑顾问委员会成员,爱思唯尔公司. .申博士已经没有披露。卡普博士没有披露。谢霆锋博士没有披露。Frucht博士没有披露。古女士没有披露。凯瑟琳改变,医学已收到个人赔偿医疗通信作为一个员工的范式。凯瑟琳改变,医学已收到个人担任克利夫兰诊所的一名雇员补偿的基础。凯瑟琳改变,医学已收到个人医疗赔偿作为一个员工的催化剂。 Katharine Alter, MD has received personal compensation for serving as an employee of AANEM. Katharine Alter, MD has received publishing royalties from a publication relating to health care. Elaine Considine, RN has nothing to disclose. Tianxia Wu has nothing to disclose. Gina Norato has nothing to disclose. Dr. Hallett has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Dr. Hallett has received research support from CALA Health. The institution of Dr. Hallett has received research support from Medtronic, Inc.. The institution of Dr. Hallett has received research support from Allergan. Dr. Hallett has received intellectual property interests from a discovery or technology relating to health care. Dr. Hallett has received publishing royalties from a publication relating to health care. Dr. Hallett has received publishing royalties from a publication relating to health care. Dr. Hallett has received publishing royalties from a publication relating to health care. Dr. Hallett has received publishing royalties from a publication relating to health care. Dr. Hallett has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Movement Disorder Society. Dr. Hallett has a non-compensated relationship as a President, Past-president with International Federation of Clinical Neurophysiology that is relevant to AAN interests or activities. Dr. Hallett has a non-compensated relationship as a President with Functional Neurological Disorder Society that is relevant to AAN interests or activities. Dr. Simpson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Allergan. Dr. Simpson has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merz.
