Muscle afferent block by intramuscular injection of lidocaine for the treatment of writer's cramp

Kaji, Ryuji; Kohara, Nobuo; Katayama, Mari; Kubori, Tamotsu; Mezaki, Takahiro; Kimura, Jun; Shibasaki, Hiroshi

doi:10.1002/mus.880180214

Cited by 57 publications

(25 citation statements)

References 8 publications

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“…An indirect action on the gamma loop is also consistent with evidence that lidocaine and alcohol, drugs that block the fusimotor drive, improve dystonia and tremor. 15,16,24 The indirect action on the gamma loop may summate with the effect of botulinum toxin on the extrafusal motor end-plate. The botulinum-induced reduction in the size of the M wave and of the H reflex can be explained by the toxin's blocking action on extrafusal nerve endings.…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin restores presynaptic inhibition of group Ia afferents in patients with essential tremor

et al. 1998

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Section: Discussionmentioning

confidence: 99%

Botulinum toxin restores presynaptic inhibition of group Ia afferents in patients with essential tremor

et al. 1998

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“…After feedback mechanisms had been suggested to play a role in laryngeal dystonia [Ludlow et al, 1990], it was demonstrated that Ia afference facilitation by tendon vibration can increase the severity of writer's cramp and that this increase can be blocked by lidocaine injections preferentially affecting the muscle spindle function [Kaji et al, 1995]. With this 'muscle afferent block' not only writers's cramp, but also mandibular dystonia could be treated [Yoshida et al, 1998].…”

Section: Bt Action On the Spinal Stretch Reflexmentioning

confidence: 99%

Botulinum Toxin: Mechanisms of Action

Dressler

Saberi²

2005

Eur Neurol

266

207

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Botulinum toxin (BT) has been perceived as a lethal threat for many centuries. In the early 1980s, this perception completely changed when BT’s therapeutic potential suddenly became apparent. We wish to give an overview over BT’s mechanisms of action relevant for understanding its therapeutic use. BT’s molecular mode of action includes extracellular binding to glycoprotein structures on cholinergic nerve terminals and intracellular blockade of the acetylcholine secretion. BT affects the spinal stretch reflex by blockade of intrafusal muscle fibres with consecutive reduction of Ia/II afferent signals and muscle tone without affecting muscle strength (reflex inhibition). This mechanism allows for antidystonic effects not only caused by target muscle paresis. BT also blocks efferent autonomic fibres to smooth muscles and to exocrine glands. Direct central nervous system effects are not observed, since BT does not cross the blood-brain barrier and since it is inactivated during its retrograde axonal transport. Indirect central nervous system effects include reflex inhibition, normalisation of reciprocal inhibition, intracortical inhibition and somatosensory evoked potentials. Reduction of formalin-induced pain suggests direct analgesic BT effects possibly mediated by blockade of substance P, glutamate and calcitonin gene-related peptide.

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“…Una inyección de 5-10 cc de lidocaína en el músculo afectado por la distonía, puede mejorarla por un periodo de 24 h, aunque si se simultanea con etanol, el efecto puede prolongarse varias semanas 41,42 .…”

Section: Rehabilitaciónunclassified

Distonía focal de mano

Proubasta

Pagonabarraga

Lamas

et al. 2014

Rev Iberoam Cir Mano

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Resumen: La distonía focal de mano es un síndrome clínico neurológico caracterizado por la existencia de contracciones musculares involuntarias, sostenidas y persistentes, que provocan movimientos y posturas anormales. Su etiología, aunque controvertida, parece estar desencadenada por la actividad repetitiva, permanente y constante de la misma. Su diagnóstico es difícil, pues no existe ningún "test" o "pruebas diagnósticas" que la confirmen. De hecho, el diagnóstico de certeza de una distonía de mano puede demorarse entre 5 y 8 años, no siendo extraño que estos pacientes hayan pasado por varias cirugías previas innecesarias antes de su diagnóstico definitivo, el cual es básicamente clínico. Es por ello, que consideramos fundamental llegar a un diagnóstico precoz, con el fin evitar pérdidas innecesarias de tiempo y dinero, e iniciar el tratamiento más adecuado. En este sentido, la interacción entre cirujanos de mano, neurólogos y fisioterapeutas se hace imprescindible.Palabras claves: Distonía Ocupacional, músico, escribiente, terapia ocupacional. Focal hand dystoniaAbstract: Focal hand dystonia is a neurological clinical syndrome characterized by the existence of involuntary muscle contractions, sustained and persistent, causing abnormal movements and postures. Its etiology, although controversial, seems triggered by repetitive, continuous and constant activity of the hand. Its diagnosis is difficult because there is no "test" or "diagnostic tests" to confirm it. In fact, the true diagnosis of hand dystonia can take between 5 and 8 years. Sometimes these patients have undergone several previous surgeries before the diagnosis is established, which is mainly clinical. An early diagnosis, in order to avoid unnecessary loss of time and money, and starting the most appropriate treatment as soon as possible is considered fundamental when dealing with such an ilness. In this sense, the interaction between hand surgeons, neurologists and physiotherapists is essential. Key words:Occupational dystonia, musician, clerk, occupational therapy. Artículo de actualización Rev ibeRameR ciR mano 2014. 42 (2) : 172-182Con el término genérico de distonía, se define un "síndrome clínico neurológico caracterizado por la existencia de contracciones musculares involuntarias, sostenidas y persistentes, que provocan movimientos y posturas anormales 1 .No es nuestro propósito realizar una extensa revisión general sobre las distonías, pues escapa completamente del objetivo de este artículo, sino que la intención del presente trabajo es la de llamar la atención sobre un tipo en particular de distonía que afecta exclusivamente a la mano y cuya etiología, aunque controvertida, parece estar desencadenada por la actividad repetitiva, permanente y constante de la misma. La profundización en su estudio, es lo que nos ha llevado a escribir dicho artículo, pues estamos convencidos de que muchos cirujanos de mano, han tenido o tienen pacientes cuya sintomatología y clínica muy bien podrían corresponder a una distonía, cuyo diagnóstico es difícil, pu...

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Muscle afferent block by intramuscular injection of lidocaine for the treatment of writer's cramp

Cited by 57 publications

References 8 publications

Botulinum toxin restores presynaptic inhibition of group Ia afferents in patients with essential tremor

Botulinum toxin restores presynaptic inhibition of group Ia afferents in patients with essential tremor

Botulinum Toxin: Mechanisms of Action

Distonía focal de mano

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