脑卒中后Holmes震颤发生率及其预后  

Morbidity and outcome of post-stroke Holmes tremor

作　　者：高飞[1,2] 刘丽旭[1,2] 陈予东[1,2] 杨宇琦 厉含之[1,2] 胡雪艳 山磊[1,2] 吴晓莉[1,2] 叶长青[1,2] GAO Fei;LIU Lixu;CHEN Yudong;YANG Yuqi;LI Hanzhi;HU Xueyan;SHAN Lei;WU Xiaoli;YE Changqing(Department of Neurology Rehabilitation,Beijing Bo'ai Hospital,China Rehabilitation Reserch Center,Beijing 100068,China;Capital Medical University School of Rehabilitation Medcine,Beijing 100068,China)

机构地区：[1]中国康复研究中心北京博爱医院神经康复科,北京市100068 [2]首都医科大学康复医学院,北京市100068

出　　处：《中国康复理论与实践》2022年第1期50-54,共5页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨脑卒中后Holmes震颤的发生率以及综合治疗的效果。方法回顾性调查2019年10月至2021年9月本院神经康复病房脑卒中患者中诊断Holmes震颤的患者,收集其临床信息、影像学表现、药物治疗方案、康复评定量表评分、康复方案和治疗效果。结果共收治脑卒中恢复期患者715例,其中Holmes震颤5例,发病率0.7%,均为脑出血患者,占脑出血恢复期患者1.7%。患者均为男性,中脑和脑桥出血3例,小脑出血1例,丘脑出血1例。震颤发病在出血后1.5~7个月,均表现为头部伴肢体震颤,同时并发其他神经功能障碍。治疗后,4例震颤好转,1例无效。患者Fugl-Meyer评定量表运动和平衡评分无明显改善(P>0.05),日常生活活动能力评分有所提高(P<0.05)。结论Holmes震颤在脑卒中患者中发生率较低。经综合治疗后,震颤大部分有所改善,但对运动功能效果不佳。Objective To investigate the incidence of Holmes tremor(HT)after stroke and its outcome after medication and rehabilitation.Methods Patients diagnosed as HT after stroke in the ward of neurorehabilitation department from October,2019 to September,2021 were reviewed the clinical features,imaging manifestations,drug treatment plan,rehabilitation evaluation scales scores,rehabilitation plan and outcome.Results There were five inpatients with HT(0.7%,5/715),and all were hemorrhagic stroke,accounting for 1.7%of hemorrhagic stroke.The lesions were located in the midbrain and pons in three cases,cerebellum in one case and thalamus in one case.The tremor appeared 1.5 to seven months after stroke,limited on head and limbs,with other neurological dysfunction.After the comprehensive treatment of drugs and rehabilitation,tremor improved in four cases,and ineffective in one case.The motor and balance function improved less,and the activities of daily living improved somehow.Conclusion The incidence of Holmes tremor is low in stroke patients.The tremor might respond to the treatment,but motor function would not.

关 键 词：脑卒中 Holmes震颤 发病率 预后 康复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]