CAJ | 학술논문

目的根据临床特征提出咀嚼肌痉挛的临床分型.方法收集2000-2010年咀嚼肌痉挛病例36例,对患者的基本情况、临床表现、痉挛发作程度、发作频率、肌电图、治疗效果统计分析,并提出临床分型.结果 ①根据临床表现和肌电图将36例病例分为闭口型痉挛和开口型痉挛两型.闭口型痉挛18例,受累肌肉为咬肌和(或)颞肌,主要表现为痉挛发作时开口受限；开口型痉挛18例,受累肌肉为翼外肌,主要表现为闭口或紧咬牙困难.②闭口型痉挛18例,14例为20 ～ 50岁,间断性发作,单侧发病；开口型痉挛18例,50岁以上13例,多持续性发作,双侧受累13例.③闭口型肌电图可分为持续型、节律型和不规则型,开口型肌电图可分为自发型和运动诱发型.④接受肉毒毒素局部注射治疗12例,症状明显改善或痉挛消失.结论咀嚼肌痉挛可分为闭口型和开口型,有各自的临床特征.
목적 근거림상특정제출저작기경련적림상분형.방법 수집2000-2010년저작기경련병례36례,대환자적기본정황、림상표현、경련발작정도、발작빈솔、기전도、치료효과통계분석,병제출림상분형.결과 ①근거림상표현화기전도장36례병례분위폐구형경련화개구형경련량형.폐구형경련18례,수루기육위교기화(혹)섭기,주요표현위경련발작시개구수한；개구형경련18례,수루기육위익외기,주요표현위폐구혹긴교아곤난.②폐구형경련18례,14례위20 ～ 50세,간단성발작,단측발병；개구형경련18례,50세이상13례,다지속성발작,쌍측수루13례.③폐구형기전도가분위지속형、절률형화불규칙형,개구형기전도가분위자발형화운동유발형.④접수육독독소국부주사치료12례,증상명현개선혹경련소실.결론 저작기경련가분위폐구형화개구형,유각자적림상특정.
Objective To determine the classification of masticatory myospasm by analyzing characteristics of clinical appearances.Methods Thirty-six cases of masticatory myospasm from 2000 to 2010 were included.The clinical data of these patients were analyzed,including patient information,patient history,clinical characteristics,severity and the frequency of myospasmodic movement,electromyogram (EMG),and the efficacy of botulinum toxin injection treatment. Results There were 11 males and 25 females,aged from 15 to 71.According to the clinical manifestation and EMG findings,patients could be divided into two groups:18 cases were classified as jaw closing type which involved masseter and/or temporalis muscles presenting as trismus and acute pain,the other 18 cases were jaw opening type which involved lateral pterygoid muscles complaining difficulty in jaw closing and teeth clenching.The jaw closing type was often seen in patients of 20 to 50 years old,the jaw opening was frequently seen in patients over 50 years old. Jaw closing type was attacked intermittently and unilaterally,but jaw opening was often attacked continually and bilaterally.The rating scale of the severity of spasmodic movement was not different between the two types,but the frequency of spasmodic attack was much higher for jaw opening type ( P ＜0.05).The EMG of jaw closing type was classified into persistent,rhythmic and irregular type.The EMG of jaw opening type was classified into spontaneous and exercise-induced type.Twelve cases were treated by botulinum toxin injection that could significantly relieve symptoms.Conclusions Masticatory myospasm can be classified into jaw closing and jaw opening types.Jaw closing type involves masseter and/or temporalismuscles and jaw opening type involves lateral pterygoid muscles. Botulinum toxin injection was the most effective therapy for the masticatory myospasm.