肌电图在肉毒毒素治疗技术中的应用  

Application of electromyography in botulinum toxin injection

作　　者：肖莉彬[1] 靳令经[1] 

机构地区：[1]同济大学附属同济医院神经内科,上海200065

出　　处：《同济大学学报（医学版）》2015年第3期128-131,共4页Journal of Tongji University(Medical Science)

基　　金：国家自然科学基金(81000481);上海市青年科技启明星计划(10QA1407500);中国医学基金会资助项目(GJYX1201)

摘　　要：肉毒毒素通过阻断突触前膜乙酰胆碱的释放,能够抑制肌肉过度收缩引起的运动障碍及姿势异常,已经成为局限性肌张力障碍和痉挛等病症的重要治疗手段。肌电图技术能够检测到肌肉静息状态、自主收缩状态、被动牵伸状态及神经受刺激后收缩等情况下的电生理活动变化,从而被广泛应用于肉毒毒素治疗中。随着痉挛责任肌肉的电生理表现、运动终板定位技术等方面的研究进展,肌电图已经成为实现肉毒毒素精准注射的关键。本文研究就肌电图在筛选过度活动的靶肌肉、引导肉毒毒素准确注入靶肌肉、选择目标肌肉内最佳注射位点及注射肉毒毒素后的疗效评价等方面的研究进展进行综述,为最大程度提高肉毒毒素疗效、减少肉毒毒素用量及不良反应奠定基础。Botulinum toxin can inhibit movement disorders and abnormal postures induced by abnormal muscle contractions through blocking presynaptic acetylcholine release. Botulinum toxin injection become has important method for focal dystonia, spasticity and other myogenic diseases. Electromyography （EMG） can detect the electrophysiological changes of muscles at different states, including resting state, voluntary contraction, passive stretch or contraction after nerve stimulation. With the progress on electrophysiological features of muscle spasm and endplate-location technique, EMG has become the key technique for precise injection of botulinum toxin. This paper focuses on the progress on the application of EMG in accurately selecting target muscles, guiding the injection, finding the best injection sites and evaluating the injection effect, which may be of value in maximizing the efficacy, reducing the dosage and adverse events of botulinum toxin injection.

关 键 词：肌电图 肉毒毒素 肌张力障碍 痉挛 

分 类 号：R741.05[医药卫生—神经病学与精神病学]