■鞘内注射巴氯芬(ITB)治疗,对于不合适的常规痉挛药物候选药物,是口服途径给药的优选方法。由于其生物利用度提高,ITB确保在目标地点更有效地交付。
■目前缺乏关于使用ITB治疗治疗痉挛型肌张力障碍非卧床患者的确凿证据。ITB泵植入前,患者通常接受ITB推注试验,以排除潜在的不良反应,并验证对高渗问题的治疗效果.在这份报告中,我们重点介绍一例痉挛性肌张力障碍,特别关注在ITB注射试验后在改良Ashworth量表(MAS)评分和步态模式方面均显示显著改善的非卧床患者.
本病例报告概述了一名67岁男性的病史,诊断为左侧偏瘫和痉挛性肌张力障碍,由于他的右丘脑颅内出血的第二次发作。开始了ITB注射试验,因为患者不适合继续注射肉毒杆菌毒素和口服药物。这是由于上肢和下肢持续发生痉挛性肌张力障碍。患者接受了为期四天的ITB注射试验,剂量逐渐增加,改善MAS评分和步态参数,包括节奏,步长,步进时间,步幅长度,步伐时间增加了。特别是,运动学步态分析表明,在僵硬的膝关节步态模式下,在摆动阶段膝关节屈曲增加有了显着改善。这些结果表明痉挛相关症状逐渐减少,表明ITB注射试验的积极作用。患者最终接受了ITB泵植入。
■在这位患有痉挛型肌张力障碍的中风后患者中,ITB治疗已证明有效和实质性的痉挛管理,随着步态模式的改善。
UNASSIGNED: Intrathecal baclofen (ITB) therapy, a viable alternative for unsuitable candidates of conventional spasticity medications, is a preferred method of administration over the oral route. Owing to its enhanced bioavailability, ITB ensures a more effective delivery at the target site.
UNASSIGNED: There is a lack of conclusive evidence regarding the use of ITB treatment in managing ambulatory patients with spastic dystonia. Before ITB pump implantation, patients commonly undergo an ITB bolus injection trial to rule out potential adverse reactions and verify the therapeutic effects on hypertonic issues. In this report, we highlight a case of spastic dystonia, particularly focusing on an ambulatory patient who demonstrated significant improvement in both the modified Ashworth scale (MAS) score and gait pattern following the ITB injection trial.
UNASSIGNED: This case report outlines the medical history of a 67-year-old male diagnosed with left-side hemiplegia and spastic dystonia, resulting from his second episode of intracranial hemorrhage in the right thalamus. An ITB injection trial was initiated because the patient was not suitable for continued botulinum toxin injections and oral medications. This was due to the persistent occurrence of spastic dystonia in both the upper and lower extremities. The patient underwent a four-day ITB injection trial with progressively increasing doses, resulting in improved MAS scores and gait parameters, including cadence, step length, step time, stride length, and stride time were increased. Particularly, kinematic gait analysis demonstrates a substantial improvement of increased knee flexion in the swing phase in stiff knee gait pattern. These findings indicated a gradual reduction in spasticity-related symptoms, signifying the positive effect of the ITB injection trial. The patient eventually received an ITB pump implantation.
UNASSIGNED: In this post-stroke patient with spastic dystonia, ITB therapy has demonstrated effective and substantial management of spasticity, along with improvement in gait patterns.