以腹肌抽动为主要表现的成人抽动症1例报告

患者 ,男 ,2 2岁 ,军人 ,未婚。患者于发热 3天后 (最高38.3℃ )出现双下肢抖动 ,伴胸闷。继而双上肢及腹部也出现颤抖 ,伴呼吸困难。入睡后症状消失 ,醒后出现腹部肌肉阵发性痉挛 ,表情痛苦。于多家医院诊治 ,考虑“癔症”,予 10 %葡萄糖酸钙 4 0 ml静推无效。针灸后症状加重 ,心理治疗效果不好。患者既往于 1年内有不自主抖动史 2次 ,均自然缓解。否认家族史。查体 :BP 17/ 10 k Pa,T 37.1℃ ,双扁桃体充血 , °大。颅神经未见异常。左偏身针刺觉呈中线型减退 ,音叉觉未见异常。左上下肢肌力 ,右侧正常 ,腱反射双侧基本对称 ,双上肢肌…     

碳酸锂致酷似抽动症1例报告

碳酸锂致酷似抽动症甚为罕见,现将临床工作中所遇1例报告如下: (?)人男性,17岁,学生,因话多、夸大、活动多3月余就诊,初诊时精神检查:意识清、仪表整洁、接触好、言语多、语流快、夸大、情感活跃、思维联想迅速、自知力缺如。体格检查无     

抽动秽语综合征伴垂体功能异常1例

1病例患者女,12岁。2003年5岁出现双手不自主抖动,吃饭时挤眼,症状较轻未引起家人注意。2005年7岁转学后出现双上肢不自主抽动,左侧为著,幅度较大,静止或活动时均可出现,时轻时重,每天数10次。2010年9月10岁至2011年2月,患者双上肢抽动加重,夜间需将上肢压住方能入睡。右手抖动,不能在纸上写字,但可勉强在竖直的黑板上写字,能用手机输字。既往无其他疾病;个人史无特殊,生长发育与     

发作性阴部疼痛型癫痫1例报告

患者 ,女 ,4岁。半年前突然阵发性、反复性哭闹诉阴部疼痛 ,不能制止地用手抓阴部。家人检查阴部无红肿 ,但患儿每次发作时表情异常痛苦 ,甚至恐惧、惊叫 ,持续 5～ 10分钟症状消失。发作后患儿呈倦怠状或入睡 ,醒后似无任何症状发生一样。发作前无任何不适 ,有时在进食中或与小朋友玩耍时突然发作 ,表现为哭闹不止 ,诉排小便处疼痛。在多家医院曾诊为尿路感染或皮肤病 ,用抗生素及氢化可的松软膏外搽无效。病初 2～ 3月发作一次 ,近 3月来渐增 ,1月甚至几天发作一次。无癫痫病家族遗传史 ,无脑外伤及寄生虫史。患儿属第二胎 ,足月顺产 ,婴…     

儿童多发性抽动症1例随访3年报告

患儿男，15岁，于2000年6月10日首次就诊，代诉：患儿自初中升学考试前，突然出现快速、无目的、重复的头向一侧晃动，动作刻板。每日10数次，发作时双上肢屈曲、用劲，家长制止时，症状可短时间自我控制，但当解除约东后，发作次数即突然增多。集体活动时不发作，睡眠时症状消失，学习与正常生活不受影响。既往无类似病史。患儿系第     

表现为四肢肌肉萎缩的神经纤维瘤病Ⅱ型1例

<正> 患者,男 44岁,进行性四肢无力伴肌肉萎缩12年,加重伴耳鸣、听力减退2年,于2002年2月28日以四肢肌肉萎缩原因待诊收住院。隐匿起病,12年前发现右手骨间肌肌肉萎缩,无明显无力症状,病情逐渐进展并波及四肢远端,近5年来出现双手精细活动时费力伴双下肢无力,但不影响日常活动。2年前出现双侧耳鸣,近9个月发现听力减退左侧为重,伴左侧面部麻木以及走路不稳。病程中偶有肢体麻木,头晕、眩晕、头憋胀感。家族中无同类病患者。入院查体:神志清楚,跛行,左侧腋窝10×12cm~2面积的雀斑,腹部脐旁有一孤立的牛奶咖啡斑(2×3cm~2),右侧第12胸椎旁皮下可触及3×6×5cm~3大小两个软组织内肿物。双侧巩膜可见粽黄色色素沉着,裂隙灯检查发现晶状体后囊部浊斑。左侧面部浅痛觉减退呈     

阿立哌唑治疗成人抽动秽语综合征1例

1病例患者,女性,32岁,无业。7岁开始出现不自主抽动,表现为频繁眨眼睛,挤鼻子,清嗓子,后症状逐渐加重,影响正常生活和学习,重复检查门窗是否关好,重复写字,诊断为“抽动秽语综合征”。曾服用氟哌啶醇、硫必利以及多种中药治疗,症状改善不明显。停药后症状逐渐加重,开始出现大声尖叫,控制不住骂人,耸肩等全身抽动。后于2002年在某医院行立体定向手术治疗,术后症状未见好转,且出现双上肢麻痹,右手控制不住戳左眼睛,致使左眼角膜受伤且丧失视力。近2年因抽动加重而不敢出门,不能工作,生活严重受到影响,因频繁尖叫而影响邻居,自知力存在,自感痛苦,     

女性糖尿病患者的阴部神经电生理表现

目的:探讨女性糖尿病患者阴部神经电生理表现。方法:对42例女性糖尿病患者(糖尿病组)进行球海绵体肌反射(BCR)及阴部神经体感诱发电位(SSEP)潜伏期及波幅的检测,并与40例不伴有周围或中枢神经病变的成年女性患者40例(对照组)进行比较。结果:糖尿病组BCR和SSEP潜伏期延长,与对照组比较差异有统计学意义(P<0.05)。结论:糖尿病患者存在阴部神经的损害,BCR和SSEP检测有助于诊断。     

以喉部屏气声为主要表现的儿童抽动症1例

8男,１２岁,小学五年级学生,３个月前无明显诱因出现不能克制的喉部屏气声,伴表情痛苦、紧张,约每分钟１２次,在紧张及家长注意时频率明显增加,注意分散时减轻,张口、饮食或入睡时完全消失。无眨眼、咬唇、摇头、歪颈、耸肩、肢体抽动或躯干扭动,无秽语、模仿言语或模仿动作。曾行脑电图、颅脑ＣＴ、肝功、胸透、肝胆Ｂ超等各项检查均无异常,收入院诊治。患者系第２胎,有一姐;足月顺产,出生后生长发育正常,平时娇生惯养,争强好胜,上小学后成绩名列前茅,因面临考初中,思想压力较大。家族成员中无类似病史,既往无重大躯体…     

Tics status: a movement disorder emergency

Journal of Neurology -     

抽动症患者感觉运动整合的异常

抽动症的发病机制尚不十分明确,简单/复杂的感觉现象可能在抽动的发生中起到重要作用.越来越多的研究使用经颅磁刺激（TMS）等方法,探究抽动症患者经皮质环路输入与传出相互影响的机制,从不同角度证实了抽动症患者感觉运动整合的异常.     

A case of post-traumatic tic disorder

We present the case of a 27-year-old man who developed multiple motor tics following closed head trauma with loss of consciousness. Age of onset, lack of family history of tics, and atypical progression of tic severity and location make it unlikely that the patient had Gilles de la Tourette syndrome. Previous reports of post-traumatic tic syndrome are discussed.     

Clonidine in a case of atypical tic disorder

Clonidine hydrochloride was more effective than placebo in the treatment of an atypical tic disorder (1) in a single case study using an A-B-A design. Furthermore, the effect was confined to a narrow dose range.     

A型肉毒毒素治疗抽动障碍

目的 探讨A型肉毒毒素治疗抽动障碍患者运动性抽动症状的疗效.方法 25例抽动障碍患者(男性20例,女性5例)接受国产A型肉毒毒素注射,治疗主要针对患者最突出的运动性抽动的表现.治疗前进行耶鲁综合抽动严重程度量表(YGTSS)基线评分,治疗1、4周和1年内分别进行YGTSS和Jankovic评分,并记录疗效的潜伏期、持续时间、副作用、患者的主观感觉和感觉先兆的变化以及再次注射情况.结果 在25例患者总共29人次的治疗中,肉毒毒素疗效平均潜伏期5.0 d,平均总体疗效持续4.6个月,平均最佳疗效Jankovic评分3.4分,根据YGTSS减分率统计62.1%(18/29)明显有效,34.5%(10/29)好转,3.4%(1/29)无效.85.7%(18/21)的患者感觉先兆减轻,平均改善72.4%(20%～100%).主要副作用为注射部位短暂而轻微的无力和皮疹.症状复发者再次注射仍然有效.结论 A型肉毒毒素对于控制抽动障碍的运动性抽动症状安全有效.     

Compulsive phenomena in children with tic disorder and attention deficit-hyperactive disorder

Tic disorders (TD), obsessive-compulsive disorders (OCD) and attention-deficit/hyperactivity disorder (ADHD) are often associated with deficits of impulse control and aggressive behavior. Tic disorders and OCD are closely related on epidemiological, psychopathological and neurobiological levels, whereas ADHD and OCD phenomena seem to be at opposite poles. Research evidence on the clinical significance of associated obsessive-compulsive behavior is reviewed and linked to our own new data. Thus the analyses of a worldwide database on Tourette's Syndrome (TS) (N = 4,833) showed that that the associated symptomatology of the OCD spectrum has to emphasized. In further investigations, premonitory sensorimotor phenomena reminiscent of OCD were more frequent in children with tic disorders as they grew older. Obsessive-compulsive behavior concomitant with TS was particularly associated with impulsive and aggressive behavior, as well as with depression and anxiety. The data suggest a reduced serotonergic transmission. Self-reports by children with ADHD, as opposed to those by their parents, mentioned a significantly higher quantitative degree of OC phenomena than those by children with TS. These findings suggest that OC symptoms in children with ADHD have so far been neglected in assessments by others. In summary, a complex psychopathological pattern of tic, OC behavior, impulsivity and internalizing symptomatology emerges that requires discriminating assessment and treatment.     

Obsessive-compulsive disorder in youth with and without a chronic tic disorder

The goal of this study was to discriminate subtypes of pediatric obsessive-compulsive disorder (OCD) among youth with and without a comorbid tic disorder. Seventy-four youth (M(age)=9.7+/-2.3 years) with a principal diagnosis of OCD, with (n=46) or without (n=28) a comorbid tic disorder, were assessed with a semi-structured diagnostic interview and the Children's Yale Brown Obsessive-Compulsive Scale (CY-BOCS). The CY-BOCS Symptom Checklist was used to categorize obsessions and compulsions. Group differences were analyzed by t tests, chi(2), and discriminant function analyses. Results suggested that subjects without tics had significantly more contamination obsessions, sexual obsessions, and counting compulsions than youth with comorbid tics. Generally speaking, however, youth with and without tics had similar symptom presentations. These data suggest that pediatric OCD patients with and without comorbid tics may have some aspects of symptom presentation that differ, but generally have more OCD symptoms in common than different. Implications of these findings on clinical presentation and treatment efficacy are highlighted.