发作性运动障碍10例临床分析

目的:探讨发作性运动障碍的临床特点、诊断、治疗及误诊原因。方法:回顾性分析发作性运动障碍患者的临床表现、影像学与EEG/video-EEG(视频脑电图)检查及治疗。结果:本组10例,男8例,女2例,起病年龄6~14岁,病程半年~9年;9例由突然的运动诱发,1例为自发发生;临床表现为姿势性肌张力障碍6例,舞蹈样动作2例,投掷样运动1例,手足徐动样动作1例,均为单侧受累;发作时间多为10余秒;6例患者每日有发作,最多1d可发作30余次;CT/MRI均正常,EEG/video-EEG大多正常(9/10);9例卡马西平治疗有效,1例氯硝西泮部分有效。结论:9例为发作性运动障碍中的阵发性运动诱发性运动异常,1例为阵发性非运动诱发性运动异常,前者抗癫药治疗能全部控制发作,后者仅部分有效。

Clinical Analysis of 10 Patients with Paroxysmal Dyskinesias

Aim:To explore the clinical features,diagnosis,treatment and misdiagnosis of paroxysmal dyskinesias (PD). Methods:To analyse retrospectively the clinical manifestation,CT/MRI,EEG/video-EEG and treatment of 10 patients with PD.Results:In this study 8 male and 2 female patients were investigated. The age of onset ranged from 6 to 14 years.The courses ranged from 0.5 to 9 years. All patients' attacks,except one was spontaneous,were triggered by sudden movement.In these patients,6 were manifested by dystonia,2 chorea,1 ballismus and 1 athetosis.All involved unilaterally.Duration of an attack mostly was about 10 seconds.6 patients attacked each day.The most frequent attacks were above 30 times a day. CT/MRI revealed no abnormality,All patients' EEG/video-EEG,except one,were also normal.9 patients responded well to carbamazepine,1 patient had partial response to clonazepam.Conclusion:Of 10 patients with PD,9 cases are paroxysmal kinesigenic dyskinesia(PKD),1 case is paroxysmal nonkinesigenic dyskinesia(PNKD). The treatment of antiepileptic drugs for the former can completely control the attacks,but for the latter can only partially control its attacks.