肢体抖动性短暂性脑缺血发作的临床分析  

Clinical analysis of limb shaking transient ischemic attack

作　　者：程巧玫 吕爱红[1] 徐晓玉[1] 曹心慧[1] 张晓曼[1] 

机构地区：[1]河南大学附属郑州市第一人民医院神经内科,郑州450004

出　　处：《医药论坛杂志》2015年第3期28-30,共3页Journal of Medical Forum

摘　　要：目的通过肢体抖动性短暂性脑缺血发作的临床表现、辅助检查,并复习文献,探讨发病机制,提高临床医师诊断的准确率。方法本院收治的5例患者,均行经颅多普勒、颈部动脉血管超声、脑电图、头颅磁共振平扫和血管成像检查,3例行全脑血管造影术,回顾分析患者的临床资料。结果 5例患者发作均有明显诱因,表现短暂性不能控制的肢体抖动。全部患者脑电图未见癫痫波,血管评估提示抖动肢体对侧颈动脉系统颅内和(或)颅外有严重血管狭窄或闭塞,给予抗血小板聚集、他汀类药物调脂、扩容或血管重建治疗,病情明显改善。结论肢体抖动性短暂性脑缺血发作提示有颈动脉颅内和(或)颅外段严重的狭窄或闭塞,发病机制可能存在低灌注,血管重建是最有效的治疗方法。Objective To probe the pathogenesis of limb shaking transient ischemic attack and improve the accuracy of diagnosis in this disease by virtue of analyzing the clinical feature and auxiliary examination, as well as reviewing referred literature. Methods Totally 5 patients with limb shaking clinical feature, having get auxiliary examination such as TCD, cervical vascular color ultrasonic inspection, EEG, magnetic resonance imaging scan and blood vessels,were payed attention to. Digital subtraction angiography （DSA） were performed in 3 of them. Clinical features of the 5 patients were reviewed with conscientious. Results Transient limb shake with known cause was observed in all 5 patients. Epileptic wave was not found in the EEG while severe vascular stenosis or occlusion appeared at corresponding carotid artery. Clinical improvement were observed after anti - platelet therapy, lipid - lowering therapy with statins and volume expansion or vascular remodeling therapy. Conclusion Limb jitter transient ischemic attack may indicate carotid stenosis or occlusion. Hypoperfusion was deemed to be one of the reasons why those patients experience limb shake. One of the best solutions is revascularization.

关 键 词：肢体抖动 短暂性脑缺血发作 动脉狭窄 低灌注 血管重建 

分 类 号：R743.3[医药卫生—神经病学与精神病学]