发作性运动障碍10例临床分析  

Clinical Analysis of 10 Patients with Paroxysmal Dyskinesias

作　　者：杨德本[1] 余巨明[1] 王顺先[1] 宋杨[1] 

机构地区：[1]川北医学院附属医院神经内科,637000

出　　处：《中国临床神经科学》2005年第3期289-291,共3页Chinese Journal of Clinical Neurosciences

摘　　要：目的:探讨发作性运动障碍的临床特点、诊断、治疗及误诊原因.方法:回顾性分析发作性运动障碍患者的临床表现、影像学与EEG/video-EEG(视频脑电图)检查及治疗.结果:本组10例,男8例,女2例,起病年龄6～14岁,病程半年～9年;9例由突然的运动诱发,1例为自发发生;临床表现为姿势性肌张力障碍6例,舞蹈样动作2例,投掷样运动1例,手足徐动样动作1例,均为单侧受累;发作时间多为10余秒;6例患者每日有发作,最多1 d可发作30余次;CT/MRI均正常,EEG/video-EEG大多正常(9/10);9例卡马西平治疗有效,1例氯硝西泮部分有效.结论:9例为发作性运动障碍中的阵发性运动诱发性运动异常,1例为阵发性非运动诱发性运动异常,前者抗癫癎药治疗能全部控制发作,后者仅部分有效.Aim：To explore the clinical features,diagnosis, treatment and misdiagnosis of paroxysmal dyskinesias （PD）. Methods：To analyse retrospectively the clinical manifestation, CT/MRI, EEG/video-EEG and treatment of 10 patients with PD.Results：In this study 8 male and 2 female patients were investigated. The age of onset ranged from 6 to 14 years,The courses ranged from 0.5 to 9 years. All patients＇ attacks,except one was spontaneous, were triggered by sudden movement. In these patients,6 were manifested by dystonia, 2 chorea, 1 ballismus and 1 athetosis.All involved unilaterally. Duration of an attack mostly was about 10 seconds. 6 patients attacked each day. The most frequent attacks were above 30 times a day. CT/ MRI revealed no abnormality, All patients＇ EEG/video-EEG, except one, were also normal.9 patients responded well to carbamazepine,1 patient had partial response to clonazepam.Conclusion： Of 10 patients with PD, 9 cases are paroxysmal kinesigenic dyskinesia（PKD）, 1 case is paroxysmal nonkinesigenic dyskinesia（PNKD）. The treatment of antiepileptic drugs for the former can completely control the attacks, but for the latter can only partially control its attacks.

关 键 词：发作性运动障碍 癫癎 脑电图 

分 类 号：R742[医药卫生—神经病学与精神病学]