Muscle Ultrasound in Clinical Neurology: Diagnostic Uses and Guidance of Botulinum Toxin Injection

U. Walter
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Abstract

Muscle ultrasound (MUS) is increasingly used by neurologists, neuropediatricians, neurosurgeons, specialized radiologists and anaesthesiologists for the imaging-supported diagnosis of neuromuscular disorders. Especially, MUS is highly sensitive in detecting fasciculations in motor neuron diseases, and in revealing intensive care unit acquired weakness. Hereditary and inflammatory myopathies are associated with distinct patters of echo-intensity changes of affected muscles. Moreover, MUS can be used for guiding needle biopsy of muscle lesions, and for targeting intramuscular botulinum neurotoxin (BoNT) injection in neurological disorders with muscle hyperactivity. MUS-guidance of BoNT injection is especially recommendable in complex cervical dystonia, in task-related hand dystonia (writer’s cramp, musician dystonia), and in children and adolescents with cerebral palsy. Modern ultrasound technologies such as sono-elastography, tissue Doppler, and high-definition microvasculature imaging allow for novel diagnostic and therapeutic uses. Recently, an international expert group reported consensus guidelines for neuromuscular ultrasound training. The present review provides a concise overview of well-established diagnostic and therapeutic applications of MUS in clinical neurology, with specific focus at MUS for targeting intramuscular BoNT injections.
肌肉超声在临床神经病学:肉毒杆菌毒素注射的诊断应用和指导
肌肉超声(MUS)越来越多地被神经科医生、神经儿科医生、神经外科医生、专业放射科医生和麻醉科医生用于神经肌肉疾病的影像学诊断。特别是,MUS在检测运动神经元疾病的束状反应和揭示重症监护病房获得性虚弱方面具有高度敏感性。遗传性和炎症性肌病与受影响肌肉回声强度变化的不同模式有关。此外,MUS还可用于指导肌肉病变的穿刺活检,以及针对肌肉多动性神经系统疾病的肌内肉毒杆菌神经毒素(BoNT)注射。在复杂的颈肌张力障碍、与任务相关的手肌张力障碍(作家痉挛、音乐家肌张力障碍)以及患有脑瘫的儿童和青少年中,特别推荐使用肌电显微镜指导BoNT注射。现代超声技术,如超声弹性成像,组织多普勒和高清微血管成像允许新的诊断和治疗用途。最近,一个国际专家组报告了神经肌肉超声训练的共识指南。目前的综述提供了一个简明的概述建立的诊断和治疗应用的MUS在临床神经学,特别侧重于MUS靶向肌肉注射BoNT。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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