帕金森综合征的异常眼球运动研究进展  

Advances in abnormal eye movements in Parkinsonian syndrome

作　　者：李铃 闫卫红 刘晓蕾 侯苗苗 LI Ling;YAN Weihong;LIU Xiaolei;HOU Miaomiao(The Third Hospital of Shanxi Medical University(Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital),Taiyuan 030032,China;Shanxi Bethune Hospital/Shanxi Academy of Medical Sciences/Tongji Shanxi Hospital,Taiyuan 030032,China)

机构地区：[1]山西医科大学第三医院(山西白求恩医院、山西医学科学院、同济山西医院),山西太原030032 [2]山西白求恩医院、山西医学科学院、同济山西医院,山西太原030032

出　　处：《中国实用神经疾病杂志》2023年第4期515-518,共4页Chinese Journal of Practical Nervous Diseases

基　　金：山西省回国留学人员科研资助项目(编号:HGKY2019096);山西省留学人员科技活动择优资助项目(编号:2018-1059-13);山西省基础研究青年项目(编号:202103021223415)。

摘　　要：帕金森综合征是指有类似帕金森病表现的多种疾病,其中包括帕金森病(PD)、多系统萎缩(MSA)、进行性核上性麻痹(PSP)。PD以震颤、肌强直、动作迟缓、姿势平衡障碍的运动症状和睡眠障碍、嗅觉障碍、自主神经功能障碍、认知和精神障碍等非运动症状为临床特征。MSA以自主神经功能障碍、帕金森病、小脑共济失调和锥体束征的不同组合为主要临床表现。PSP是一种非典型帕金森综合征,早期可出现步态不稳所致跌倒,可见核上性凝视麻痹或迟缓,锥体外系肌强直,伴皮层下认知和精神行为改变。不正常的眼球运动很常见,有时在运动障碍性疾病中也很突出。眼球运动检查包括床边评估和实验室记录眼球错位、不自主眼球运动,包括眼球震颤和扫视侵入、视振荡、诱发性眼球震颤、扫视、平滑跟踪和前庭眼反射。眼动检查已被证明是鉴别帕金森综合征的一个极好的工具。本文综述PD、MSA及PSP的眼动特征,旨在为三者的鉴别诊断提供依据。Parkinsonian syndrome refers to a variety of disorders with Parkinson's-like manifestations,including Parkinson's disease(PD),multiple system atrophy(MSA),and progressive supranuclear palsy(PSP).PD is characterised clinically by motor symptoms such as tremor,myotonia,bradykinesia and postural instability and non-motor symptoms such as sleep disturbances,olfactory disturbances,autonomic dysfunction,cognitive and psychiatric disorders.MSA is characterized by different combinations of autonomic failure,Parkinson's disease,cerebellar ataxia and pyramidal fasciculations as the main clinical manifestations.PSP is an atypical Parkinsonian syndrome that may present early with falls due to gait instability,supranuclear ophthalmoplegia,and extrapyramidal muscle tonus with subcortical cognitive and psychobehavioural changes.Abnormal eye movements are common and sometimes prominent in movement disorders.Oculomotor examination includes bedside assessment and laboratory documentation of nystagmus,involuntary eye movements including nystagmus and sweep intrusion,visual oscillations,evoked nystagmus,sweep,smooth tracking and vestibulo-ocular reflex.The relevance of oculomotor examination has grown with the development of Parkinsonian syndrome and has proven to be an excellent tool for identifying it.This article reviews the oculomotor features of PD,MSA and PSP with the aim of providing a basis for the differential diagnosis of the three.

关 键 词：帕金森病 多系统萎缩 进行性核上性麻痹 眼震 扫视 平滑跟踪 视动性眼球震颤 

分 类 号：R742.5[医药卫生—神经病学与精神病学]