肢体抖动短暂性脑缺血发作临床分析

目的探讨肢体抖动短暂性脑缺血发作（（lmib—shaking transient ischemict tack，LS-TIA）的临床特点，提高临床医生对本病的认识。方法回顾性分析了我院2004—2009年问诊治的6例kS—TIA患者的临床资料。结果6例患者均表现为肢体发作性短暂不能控制的抖动，4例发作有明显诱因，其中2例曾被误诊为癫痫，给予抗癫痫治疗无效。全部患者均有抖动肢体对侧至少1条以上颅内和（或）颅外动脉严重狭窄或闭塞，头部核磁共振2例显示抖动肢体对侧分水岭脑梗死，发作期脑电图检查未见癫痫波释放，给予抗血小板聚集、扩容、血管重建术治疗后，症状均消失。结论发作性肢体抖动要考虑到LS—TIA的可能，其通常提示大血管严重狭窄或闭塞，抗栓或血管重建术可能是有效的治疗方法。

Clinical analysis of limb-shaking transient ischemic attack

Objective To study the clinical manifestations in six patients with limb-shaking transient ischemic attack (LS-TIA) in order to improve the recognition of this disorder.Methods We retrospectively analyzed the clinical data of 6 patients with LS-TIA who received treatment in our hospital from 2004 to 2009.Results The clinical features included a paroxysmal,brief,involuntary limb-shaking.Four patients had obvious precipitating factors.2 patients were misdiagnosed as epilepsy.And antiepileptic had no effect.The contralateral internal cervical artery or middle cerebral artery showed critical stenosis or occlusion.In all six patients,the brain MRI showed typical watershed cerebral infarction in 2patients,video-EEG studies failed to show epileptiform activity.The antiplatelet drugs,volum dilution therapy or percutaneous angioplasty were administered in six patients.All of them became asymptomatic.Conclusion LS-TIA is one form of transient ischemic attacks.The patients with LS-TIA almosthave severe carotid occlusive disease,and the antiplatelet drugs or percutaneous angioplasty was effective for limb-shaking.