继发于中脑梗死的Wernekink连合综合征合并Holmes震颤一例并文献复习  被引量:1

Wernekink commissure syndrome and Holmes tremor secondary to midbrain stroke:a case report and literature review

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作  者:夏小茜 贺敬红[1] 畅雪丽[1] 郭军红[1] 张炜[1] Xia Xiaoqian;He Jinghong;Chang Xueli;Guo Junhong;Zhang Wei(Department of Neurology,the First Hospital,Shanxi Medical University,Taiyuan 030001,China)

机构地区:[1]山西医科大学第一医院神经内科,太原030001

出  处:《中国脑血管病杂志》2021年第5期331-333,348,共4页Chinese Journal of Cerebrovascular Diseases

基  金:山西省科技成果转化引导专项(201704D13111584)。

摘  要:中脑梗死引起Wernekink连合综合征较罕见,主要表现为双侧小脑功能障碍、构音障碍、核间性眼肌麻痹与软腭震颤,软腭震颤一般出现在恢复期。作者报道1例继发于中脑梗死的Wernekink连合综合征合并Holmes震颤患者,神经系统体格检查示构音障碍,左前核间性眼肌麻痹和双侧小脑功能障碍,头部MR显示左侧中脑被盖尾端亚急性腔隙性脑梗死,给予阿司匹林和氯吡格雷双重抗血小板聚集治疗及抗高血压病、抗糖尿病和他汀类药物二级预防,治疗15 d后,共济失调症状有所改善,出院当天患者出现较早的头部震颤,即Holmes震颤。作者系统检索相关文献并复习已报道的相关病例,总结临床特征,发现双侧小脑共济失调与构音障碍是Wernekink连合综合征的主要临床特点,核间性眼肌麻痹和软腭阵挛及Holmes震颤较常见。Wernekink commissure syndrome caused by midbrain infarction is rare and mainly presents with bilateral cerebellar ataxia,dysarthria,internuclear ophthalmoplegia and delayed soft palate tremor.Delayed soft palate tremor usually occurs during the recovery period.A patient with Wernekink commissure syndrome and Holmes tremor secondary to midbrain infarction was reported.Neurophysical examination revealed dysarthria,left anterior internuclear ophthalmoplegia and bilateral cerebellar dysfunction.Cranial MR suggested acute lacunar infarction in left caudal midbrain.Fifteen days after dual antiplatelet therapy with Aspirin and Clopidogrel and secondary prophylactic antihypertensive,antidiabetic and statins medications,the symptoms of ataxia improved,but on the day of discharge,the patient developed earlier head tremors,known as Holmes tremor,than expected.The authors systematically searched relevant literatures,reviewed reported cases and summarized its clinical features.It was found that bilateral cerebellar ataxia and dysarthria were the main clinical features of Wernekink commissure syndrome.Internuclear ophilomaplegia,soft palate tremor and Holmes tremor were not uncommon.

关 键 词:中脑梗死 Wernekink连合综合征 Holmes震颤 

分 类 号:R743.33[医药卫生—神经病学与精神病学] R742.1[医药卫生—临床医学]

 

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