注射用氢溴酸高乌甲素致帕金森样综合征

1例75岁男性患者因肺癌骨转移给予注射用氢溴酸高乌甲素4mg溶于5%葡萄糖注射液250ml静脉滴注、1次/d。用药1次后,患者出现肌肉震颤,以四肢为主,坐立位明显,平躺后消失。用药2次后患者肌肉震颤加重,导致生活不能自理,手不能持物,行走困难。肌肉震颤症状发作期间患者除肌张力增加外,无其他异常体征。考虑为高乌甲素所致锥体外系反应(帕金森样综合征)。遂停用高乌甲素,其余治疗方案未变。停用高乌甲素后约24h,患者肌肉震颤症状消失,观察8 d,症状未再出现。

Parkinson-like symptoms induced by lappaconitine hydrobromide for injection

A 75-year-old male patient received an IV infusion of lappaconitine hydrobromide for injection 4mg dissolved into 5%glucose injection 250ml once daily due to bone metastases of lung cancer.After a single time of lappaconitine treatment,the patient developed muscle tremor mainly in the limbs,which was obvious in the sitting and standing positions and disappeared after lying flat.After 2 times of lappaconitine treatment,the muscle tremor was aggravated and he was unable to take care of himself due to tremor,showing that his hands could not hold things and walking was difficult.No other abnormal signs were found except the increase of muscle tension.The extrapyramidal symptoms(Parkinson-like symptoms)induced by lappaconitine was considered.Then lappaconitine was stopped and other treatments continued.About 24hours of lappaconitine withdrawal,the patient′s muscle tremor disappeared.After 8 days of observation,his symptoms did not recur.