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首页> 外文期刊>Journal of neurology >Safety and efficacy of botulinum toxin A for the treatment of spasticity in amyotrophic lateral sclerosis: results of a pilot study
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Safety and efficacy of botulinum toxin A for the treatment of spasticity in amyotrophic lateral sclerosis: results of a pilot study

机译：肉毒杆菌毒素A治疗肌萎缩性侧索硬化症痉挛的安全性和有效性：一项初步研究的结果

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摘要

Spasticity can be a very disabling problem in some amyotrophic lateral sclerosis (ALS) phenotypes, such as upper motor neuron-dominant ALS (UMN-D ALS) and primary lateral sclerosis (PLS). Our aim is to describe the safety and efficacy of botulinum toxin A (BoTox-A) for improving gait in those ALS phenotypes. UMN-D ALS and PLS outpatients experiencing gait disturbances, secondary to moderate-to-severe spasticity despite optimized oral medication, were offered BoTox-A treatment. Stretching exercises were indicated to complement BoTox-A effect, and ankle-foot orthotics were prescribed when appropriate. Tolerance (muscle strength, disease progression rate) and efficacy (10-m walk test) were measured at baseline and after treatment. Eight out of 122 ALS outpatients were offered BoTox-A treatment. One declined and the other seven were administered BoTox-A in the lower limbs, every 5-8 months. All of them experienced improvement in the clinical outcome and all but one referred subjective improvement. Moreover, after a median follow-up of 16 months and three injections, BoTox-A effect was maintained with no adverse events. This study provides class IV evidence that BoTox-A is safe , and could be beneficial in the short term and long term in a subset of ALS patients with moderate-to-severe spasticity.
机译：在某些肌萎缩性侧索硬化症（ALS）表型中，例如上运动神经元占优势的ALS（UMN-D ALS）和原发性侧索硬化症（PLS），痉挛可能是一个非常残疾的问题。我们的目的是描述肉毒杆菌毒素A（BoTox-A）改善那些ALS表型步态的安全性和有效性。为UMN-D ALS和PLS门诊患者提供了BoTox-A治疗，这些患者具有步态障碍，尽管中等剂量至重度痉挛，但尽管口服药物的治疗效果最佳。进行拉伸运动以补充BoTox-A效果，并在适当时开具踝足矫形器。在基线和治疗后测量耐受性（肌肉力量，疾病进展速度）和功效（10米步行测试）。 122位ALS患者中有8位接受了BoTox-A治疗。每5至8个月，有1例患者下降，而其他7例在下肢使用了BoTox-A。他们所有人的临床结局都得到了改善，除一名以外，其他人都提到主观的改善。此外，在进行了16个月的中位随访和3次注射后，BoTox-A的作用得以保持，没有不良事件。这项研究提供了IV类证据，证明BoTox-A是安全的，并且对于部分中度至重度痉挛性ALS患者的短期和长期获益。

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