PDF(Pubmed)
Abstract：
As multiple indications for botulinum toxin injections (BTIs) can coexist for neurological patients, there are to date no description of concomitant injections (CIs) to treat both spasticity and neurogenic detrusor overactivity incontinence (NDOI) in patients with spinal cord injuries (SCIs) and multiple sclerosis (MS). We therefore identified patients followed at our institution by health data hub digging, using a specific procedure coding system in use in France, who have been treated at least once with detrusor and skeletal muscle BTIs within the same 1-month period, over the past 5 years (2017-2021). We analyzed 72 patients representing 319 CIs. Fifty (69%) were male, and the patients were mostly SCI (76%) and MS (18%) patients and were treated by a mean number of CIs of 4.4 ± 3.6 [1-14]. The mean cumulative dose was 442.1 ± 98.8 U, and 95% of CIs were performed within a 72 h timeframe. Among all CIs, five patients had symptoms evocative of distant spread but only one had a confirmed pathological jitter in single-fiber EMG. Eleven discontinued CIs for surgical alternatives: enterocystoplasty (five), tenotomy (three), intrathecal baclofen (two) and neurotomy (one). Concomitant BTIs for treating both spasticity and NDOI at the same time appeared safe when performed within a short delay and in compliance with actual knowledge for maximum doses.
摘要：
作为肉毒杆菌毒素注射（BTIs）的多种适应症可以共存于神经系统患者，迄今为止,尚无关于同时注射(CIs)治疗脊髓损伤(SCI)和多发性硬化(MS)患者痉挛和神经源性逼尿肌过度活动性尿失禁(NDOI)的描述.因此，我们通过健康数据中心挖掘确定了在我们机构跟踪的患者，使用法国使用的特定程序编码系统，在相同的1个月内至少接受过一次逼尿肌和骨骼肌BTI治疗的人，过去5年（2017-2021年）。我们分析了72例319CI患者。50人（69%）是男性，患者主要为SCI(76%)和MS(18%)患者,接受治疗的CIs平均数为4.4±3.6[1-14].平均累积剂量为442.1±98.8U，95%的CI在72小时内进行。在所有CI中，5例患者出现远处传播症状,但只有1例患者在单纤维肌电图中出现病理性抖动.11种手术替代方案的中断CI：小肠膀胱成形术（5种），肌腱切开术（三），鞘内注射巴氯芬（两个）和神经切开术（一个）。在短时间内进行并符合最大剂量的实际知识时，同时治疗痉挛和NDOI的伴随BTI似乎是安全的。
