不同类型肌肉颤搐的病因与肌电图表现  

The pathogeny and electromyography of myokymia

作　　者：邵良[1] 丁莉[1] 赵菁[1] 黄国祥[1] 李新玲[1] 李嘉[1] 汪芳[1] 黄怀宇[1] 

机构地区：[1]江苏南通大学第二附属医院神经内科,南通226001

出　　处：《中华物理医学与康复杂志》2010年第8期588-591,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的 探讨原发性和症状性肌肉颤搐的病因与肌电图特征.方法 对43例具有肌颤搐症状患者的临床表现和神经电生理检测进行分析.结果 43例肌颤搐患者中27例有病因可循,为症状性肌颤搐（SM）,见于低盐综合征、甲状腺毒症、肾功能衰竭、慢性消耗性疾病（胃癌、肝癌）、放射性臂从神经病、铅中毒、慢性炎症性脱髓鞘性多发性神经根神经病、琥珀胆碱麻醉、不安腿综合征、Isaac综合征等病,SM中面肌颤搐则见于脑干肿瘤、后颅窝肿瘤、多发性硬化等;16例肌颤搐患者无明确病因,为原发性肌颤搐（PM）,包括特发性和良性肌颤搐.SM较PM肌颤搐持久且强度更大,两者肌电图均出现肌颤搐电位,大多数SM还伴有肌强直放电.结论 SM和PM的病因与肌电图特征迥异.Objective To research the pathogeny and the electromyographic characteristics of myokymia.Methods The clinical features and electromyography of 42 elderly patients with myokymia were examined. Results Symptomatic myokymia （SM） in 27 cases was caused by low salt syndrome, thyrotoxemia, urinaemia, chronic wasting diseases （such as carcinoma of the stomach or liver）, brachial plexus neuropathy, lead poisoning, chronic inflammatory demyelinating polyradiculoneuritis, succinylcholine narcosis, restless leg syndrome or Isaac＇s syndrome.Symptomatic facial myokymia was caused by neoplasm of the brain stem or in posterior cranial fossa, multiple sclerosis or other causes. Primary myokymia （ PM ） in 15 cases involved idiopathic generalized and benign myokymia.Compared with PM, SM was more constant and powerful. Myokymia potential appeared in the electromyograms of 42 of the patients. The majority of patients with SM had accompanying myotonic discharge. Conclusion The pathogeny and electromyographic characteristics of symptomatic myokymia are different from the primary stage.

关 键 词：肌颤搐 神经电生理检测 鉴别诊断 

分 类 号：R746[医药卫生—神经病学与精神病学]