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1.
应重视帕金森病的诊断与治疗   总被引:1,自引:1,他引:0  
运动障碍性疾病(movement disorders)是一组以随意运动迟缓、不自主运动、肌张力异常、姿势步态障碍等运动症状为主要表现的神经变性疾病、主要分为肌张力增高运动减少[帕金森病(PD)]和肌张力降低-运动过多[亨廷顿病(HD)]两大症候群。随着人口老龄化,帕金森病作为典型的运动障碍性疾病,其发病率和患病率在全球尤其是我国老年人群中呈现明显增长趋势。该病是由于脑深部黑质  相似文献   

2.
第13届国际帕金森病会议纪要   总被引:23,自引:0,他引:23  
第13届国际帕金森病会议于1999年7月24~28日在加拿大温哥华举行,参加会议的代表来自46个国家的2500多名。我国有30多名代表参加了会议,王新德教授被选为会议咨询委员。会议上交流了近500多篇论文,内容包括帕金森病的流行病学、遗传学、病理学、药物治疗、康复治疗、手术治疗研究等广泛的领域。一、流行病学研究Weitzel对2个岛上居民的调查发现挪威的Rogaland岛居民帕金森病的患病率(209.0/10万人口)明显高于丹麦南部地Ais岛居民的患病率(98.3/10万人口),说明该病发病率有明显的地区差异,提示遗传易患性和环境因素起着作用。…  相似文献   

3.
帕金森病的外科治疗现状和未来   总被引:13,自引:2,他引:11  
帕金森病 (Parkinson sdisease ,PD)是一种常见的中枢神经系统退行性疾病 ,主要好发于中老年人 ,我国在 6 0年代由王忠诚院士牵头组织的普查结果 ,帕金森病的患病率为 81/ 10万 ,随着老龄化社会的到来 ,帕金森病的患病人数有增加的趋势 ,欧美发达国家 6 0岁以上人群患病率为千分之一 ,发病率可达百分之一。帕金森病属于运动障碍性疾病 ,患病后出现肢体震颤、僵直、运动迟缓和姿势平衡障碍以及植物神经症状 ,病情呈进行性加重 ,严重限制病人的活动能力和影响病人的生活质量 ,给病人造成了极大的痛苦 ,也给社会和家庭带来…  相似文献   

4.
<正>帕金森病(Parkinson's disease,PD)是神经系统第二大变性病,影响着世界约5千万人口。Karin Wirdefeldt等[1]在总结了世界各地流行病学资料后于2011年发表了1篇文献中指出PD的发病率为(1.5~22)/10万人年,其患病率约为(167~5 703)/10万。PD患病率随着年龄增长而明显增高,陈生弟[2]通过调查得出50~59岁PD患病率为25.1/10万,  相似文献   

5.
帕金森病患者通常伴随多种非运动症状,随病程进展,大部分非运动症状可以呈现类似运动波动的变化,称之为非运动症状波动。非运动症状波动发生频率较高,是影响帕金森病患者生活质量的重要原因,临床诊治过程中应受到重视。文中从流行病学特点和临床表现、危险因素、发生机制、临床干预等方面对帕金森病非运动症状波动相关研究进行综述。  相似文献   

6.
帕金森病(Parkinson’s disease PD)是一种以黑质多巴胺能神经元变性缺失和路易小体形成为病理特征,并以静止性震颤、运动迟缓、肌强直和姿势步态异常等运动功能障碍为主要表现的神经系统变性疾病。Zhang ZX等研究发现55岁以上的中国人患病率为,岁以上患病率为  相似文献   

7.
帕金森病痴呆相关临床研究进展   总被引:1,自引:0,他引:1  
帕金森病是临床常见的神经变性病,以运动症状和非运动症状为主要临床特征。帕金森病痴呆是其中常见的非运动症状,发生率和病残率较高,治疗效果不理想。近年国际上关于帕金森病痴呆的基础与临床研究取得新进展。本文拟从临床视角对帕金森病痴呆的流行病学特征、神经心理学特征、预测因素、诊断及药物治疗进展进行综述,以期有助于推动国内帕金森病痴呆的研究。  相似文献   

8.
帕金森病(Parkinson's Disease,PD)是一种常见的神经系统退行性疾病,临床主要表现为静止性震颤、运动迟缓、肌强直和姿势步态异常,病理特征是黑质多巴胺(Dopamine,DA)能神经元变性缺失和路易小体(Lewybody,LB)的形成。发病年龄多在60岁以上,其发病率随年龄的增加而增高,65岁以上的老年人群患病率为1%~2%。我国的帕金森病患者人数已经超过了200万。  相似文献   

9.
帕金森病(Parkinson's disease,PD)又名震颤性麻痹,是由于黑质-纹状体通路多巴胺能神经元变性死亡而发生的一种慢性进行性疾病,使调节运动的神经递质多巴胺和乙酰胆碱失去平衡,导致少动-强直症状。该病以静止性震颤、肌僵直、运动迟缓,姿势反射异常为主要临床表现。其病因目前仍不清楚。据流行病学统计,55岁以上的老年人口中,大约1%的人患有帕金森病,西方发达国家的发病率和我国差不多,估计在中国约有200万人患有此病。  相似文献   

10.
帕金森病时额叶认知功能改变的研究进展   总被引:1,自引:0,他引:1  
帕金森病是一种常见的神经系统变性疾病,多发于老年人。我国帕金森病的标准化患病率为10.8/10万人,标准化发病率为每年0.9/10万人。其病理特征是黑质致密部多巴胺能神经元选择性  相似文献   

11.
Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.  相似文献   

12.
B. J. Wilder 《Epilepsia》1987,28(S2):S1-S7
Summary: The long-standing practice of polypharmacy in treating epilepsy is giving way to use of monotherapy. Monotherapy can improve seizure control as well as reduce the risk of serious idiosyncratic reactions, dose-related side effects, and complex drug interactions. Monotherapy also offers improved compliance and cost-effectiveness. The basis of monotherapy is accurate diagnosis and assessment of the patient's seizure type(s), followed by selection of a single appropriate anticonvulsant drug. Many patients currently treated with multiple anticonvulsants can be successfully converted to monotherapy with a carefully monitored program in which troublesome and redundant drugs are gradually withdrawn from the therapeutic regimen.  相似文献   

13.
Diagnostic Difficulties and Treatment Implications   总被引:1,自引:0,他引:1  
Robert J. Gumnit 《Epilepsia》1987,28(S3):S9-S13
Summary: Differentiation between types of epileptic seizures has been aided in recent years by the introduction of intensive neurodiagnostic techniques and the development of increasingly detailed classification systems. Paradoxically, these developments have not simplified the task of matching the appropriate antiepileptic drug to a particular seizure type. It is reasonable to assume that anticonvulsant drugs will have different effects on different types of seizures, but faulty, circular reasoning can enter the picture if one also assumes that responses of seizures to different drugs signify different seizure types. There are several examples of differential diagnoses that can fall prey to this problem, including the diagnosis between partial seizures with secondary generalization and generalized tonic-clonic seizures, and the diagnosis between complex partial seizures and absence seizures with automatisms, among others. Considerations of etiology in future classification systems can further complicate the problem: should one then choose an anticonvulsant drug on the basis of individual seizure type or on the basis of the type of epilepsy? Ramifications of this issue extend even to the drug approval process. Official sanction is not given for use of a drug for a seizure type not included in the original efficacy studies, even if later scientific evidence shows that seizure type to be related to a type that is included. New trials must be undertaken. These problems arise from how we choose to classify seizures.  相似文献   

14.
Cognitive Dysfunction Associated with Antiepileptic Drug Therapy   总被引:7,自引:5,他引:2  
Eileen P.G. Vining 《Epilepsia》1987,28(S2):S18-S22
Summary: Epilepsy is frequently associated with cognitive dysfunction. However, the reasons for this correlation are unclear. Possible influential factors include patient age; duration, frequency, etiology, and type of seizures; hereditary factors; psychosocial issues; and antiepileptic drug (AED) therapy. Whereas many of these factors are beyond the physician's control, AED therapy is one element that can be addressed in treatment decisions by recognizing the potential cognitive effects of particular AEDs. For example, phenobarbital impairs memory and concentration; phenytoin affects attention, problem solving ability, and performance of visuomotor tasks. In contrast, carbamazepine may affect concentration, while valproate would appear to have minimal effects on cognition. Moreover, cognitive effects of AEDs are amplified with coadministration of multiple anticonvulsants (polytherapy). A review of studies on the cognitive effects of monotherapy with AEDs, as opposed to those of polytherapy, provides evidence that drug-related cognitive dysfunction can be reversed if patients are switched to a simpler therapeutic regimen. Future research should be directed toward developing reliable measures for assessing and monitoring cognition, and understanding the particular cognitive side effects of each AED. Physicians also need to revise their opinions about which side effects are "tolerable" for epileptic patients.  相似文献   

15.
Hepatic Considerations in the Use of Antiepileptic Drugs   总被引:5,自引:4,他引:1  
Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.  相似文献   

16.
Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.  相似文献   

17.
Dextromethorphan: Cellular Effects Reducing Neuronal Hyperactivity   总被引:5,自引:1,他引:4  
G. Trube  R. Netzer 《Epilepsia》1994,35(S5):S62-S67
Summary: Dextromethorphan is a dextrorotary morphinan without affinity for opioid receptors, commonly used as an antitussive medication. During the past 5 years, interest in the compound and its demethylated derivative, dextrorphan, has been revived because additional neuroprotective and an-tiepileptic properties were found in in vitro studies, animal experiments, and a few clinical cases. Both morphinans are able to inhibit N -methyl-D-aspartate (NMDA) receptor channels and voltage-operated calcium and sodium channels with different potencies. The inhibition of the NMDA receptor is believed to be the predominant mechanism of action responsible for the anticonvulsant and neuroprotective properties of the compounds.  相似文献   

18.
Summary: Carbamazepine and phenytoin are drugs of choice in initial monotherapy for adult partial and secondarily generalized tonic-clonic seizures. These designations reflect the results of the Veterans Administration Epilepsy Cooperative Study Group of 1985. An earlier comparative study of carbamazepine and phenytoin by Ramsay and associates found both drugs equally effective in controlling new-onset seizures. Among the advantages of carbamazepine is that it causes relatively few cognitive and dysmorphic side effects. Its disadvantages are its unavailability in parenteral formulation and its metabolic autoinduction. The latter must be compensated for by planned dosage increases to maintain therapeutic plasma steady-state levels during the first 2 or 3 months of treatment. Carbamazepine is judged a drug of choice in the treatment of these secondarily generalized tonic-clonic seizures, and the drug of choice in children, adolescents, and women susceptible to the dysmorphic side effects associated with other anticonvulsant agents.  相似文献   

19.
Summary: Four broad categories of basic phenomena are pertinent to developing ways to prevent epilepsy. These include mechanisms of epileptogenesis, ictal initiation and temporary entrainment by the seizure discharge of normally functioning brain, seizure propagation, and control mechanisms that function both to restrain the cascade of epileptic events culminating in a seizure and to arrest the epileptic event and restore the interictal state. In newborns and children, hypoxia-ischemia is a major factor leading to epileptogenesis, and several schemes are proposed to classify, quantify, and prevent hypoxic-ischemic encephalopathy. Control mechanisms must be better understood in order to develop prophylactic recommendations for epilepsy, and an experimental model of "kindling antagonism" may increase our understanding of these. Programs of prevention of seizures in children will evolve only if basic researchers and clinicians work productively together to develop an adequate understanding of factors important in epileptogenesis and antiepileptogenic control mechanisms.  相似文献   

20.
S. FELDMAN 《Epilepsia》1971,12(3):249-262
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