背景:患有脊髓损伤(SCI)和不完全瘫痪的患者可能由于激动剂和拮抗剂肌肉的功能损害而经历肌肉固定。这会引起痉挛和疼痛,随着固定时间的增加,挛缩的风险增加。这可能会因为疼痛而加剧,这会干扰康复。对于急性SCI引起的疼痛和关节挛缩,尚无确定的治疗方法。肉毒杆菌疗法在缓解肌肉紧张中起作用。这里,我们报道了一例急性SCI患者,其中采用了肉毒杆菌治疗.
方法:患者因道路交通事故而出现C5-宫颈SCI,C5以下上肢和下肢明显瘫痪。患者自脊髓损伤后肘部持续屈曲,并抱怨剧烈疼痛,使充分的康复变得困难。在SCI后15天向肱二头肌和肱肌施用肉毒杆菌毒素。给药后,患者的疼痛随着肘部屈肌的放松而减轻,恢复康复治疗。这个病人的挛缩没有恶化,他的疼痛减轻了,他能够开始自我喂养训练。
结论:在这种情况下,职业和物理治疗与肉毒杆菌治疗一起进行。一起,他们成功地减轻了疼痛。肉毒杆菌治疗提供镇痛和肌肉松弛,并可能导致功能恢复,我们相信即使在急性期也可以考虑治疗。
BACKGROUND: Patients with spinal cord injury (SCI) and incomplete paralysis may experience muscle immobilization due to functional impairment of agonist and antagonist muscles. This can induce spasticity and pain, with the risk of contracture increasing as the period of immobilization increases. This could be aggravated by pain, which interferes with rehabilitation. There is no established treatment for pain and joint contractures caused by acute SCI. Botulinum therapy plays a role in relieving muscle tension. Here, we report a
case of acute SCI in which botulinum therapy was administered.
METHODS: The patient experienced a C5-cervical SCI due to a road traffic accident, with marked paralysis in the upper and lower limbs below the C5 level. The patient had persistent elbow flexion since the SCI and complained of excruciating pain, making adequate rehabilitation difficult. Botulinum toxin was administered to the biceps and brachialis muscles 15 days after the SCI. After administration, the patient experienced a reduction in pain with relaxation of the elbow flexor muscles, and rehabilitation treatment was resumed. This patient\'s contracture did not worsen, his pain decreased, and he was able to initiate self-feeding training.
CONCLUSIONS: In this
case, occupational and physical therapy was administered with botulinum therapy. Together, they successfully reduced pain. Botulinum therapy provides analgesia and muscle relaxation and may lead to functional recovery, and we believe that treatment can be considered even in the acute phase.