肢体抖动短暂性脑缺血发作的临床和影像学特点  

Clinical and imaging features of limb-shaking transient ischemic attacks

作　　者：唐敏[1] 刘晓亭[1] 朱幼玲[1] 周群[1] 席春华[1] 翟登月[1] 

机构地区：[1]合肥市第一人民医院(安徽医科大学第三附属医院)神经内科,230001

出　　处：《临床神经病学杂志》2017年第2期134-136,共3页Journal of Clinical Neurology

摘　　要：目的探讨肢体抖动TIA(LS-TIA)的临床和影像学特点。方法采集14例有颈内动脉狭窄的LS-TIA患者(LS-TIA组)及28例有颈内动脉狭窄的无发作性肢体抖动的TIA或轻微症状的缺血性卒中患者(TIA对照组)的临床资料并进行比较。总结LS-TIA患者临床及影像学特点。结果 LS-TIA患者均以发作性肢体抖动症状来就诊,发作时无肢体强直阵挛,无意识丧失和大小便失禁症状,无面肌受累。LS-TIA患者发作持续时间通常<5 min,发作的部位以单侧上肢多见,常见发病诱因包括站立后行走、运动及咳嗽。LS-TIA组患者高血压病的比例明显高于TIA对照组(P<0.05)。LS-TIA组患者临床表现为其他皮质TIA表现、黑矇、进展为缺血性卒中的比例均明显高于TIA对照组(均P<0.05)。LS-TIA组患者较TIA对照组有更多的软脑膜侧支。结论 LS-TIA是一种少见表现形式的TIA,特征性表现为反复发作的单侧肢体不自主的抖动,颈内动脉狭窄是其发病基础,且更易进展为缺血性卒中,其更依赖于来自严重病变颈内动脉远端的侧支循环血流供应。Objective To investigate the clinical characteristics and imaging features of limb-shaking TIA （ LS- TIA）. Methods The clinical data of 14 patients with internal carotid artery stenosis and LS-TIA （LS-TIA group） and 28 patients with TIA or minor disabling ischemie stroke associated with internal internal carotid artery stenosis, but without paroxysmal limb-shaking （TIA control group） were collected and compared. The clinical and imaging features of patients with LS-TIA were analyzed and summarized. Results The patients of LS-TIA group all came to the hospital for paroxysmal limb-shaking symptoms. But the attack didnt express body entasia, loss of consciousness, gatism and facial involvement. Limb-shaking usually lasted 〈 5 min and was often involved unilateral upper limb. Common pathogenesis inducement included standing after walking, sports and cough. The incidence of hypertension in LS-TIA group was significantly higher than that in TIA control group （ P 〈 0. 05 ）. The rates of other recurrent types of transient ischemic attack in other cortical areas, amanrosis and ischemic stroke in LS-TIA group were significantly higher than those in TIA control group （ all P 〈 0. 05 ）. Patients in LS-TIA group more often had leptomeningeal collaterals than TIA control group. Conclusions LS-TIA is a rare manifestation of TIA that has been characteristic for recurrent unilateral limb-shaking of involuntary. And the pathogenetic basis of LS-TIA is internal carotid artery occlusion. Patients with LS-TIA more frequently tend to occur ischemic attacks and more depend on the collateral circulation of severe lesions on the far side of internal carotid artery stenosis.

关 键 词：肢体抖动 TIA 缺血性卒中 颈内动脉狭窄 

分 类 号：R743.31[医药卫生—神经病学与精神病学]