Münchau A, Mathen D, Cox T, Quinn N P, Marsden C D, Bhatia K P
University Department of Clinical Neurology, Institute of Neurology, Queen Square, London WC1N 3BG, UK.
J Neurol Neurosurg Psychiatry. 2000 Oct;69(4):494-8. doi: 10.1136/jnnp.69.4.494.
To interpret clinical features after unilateral lesions of the globus pallidus on the basis of physiology of the basal ganglia.
Four patients with unilateral lesions in the globus pallidus (GP) were clinically examined and the literature on patients with pallidal lesions was reviewed.
Three patients presented with contralateral dystonia largely confined to one arm in one case and one leg in two cases. One patient had predominant contralateral hemiparkinsonism manifested mainly as micrographia and mild dystonia in one arm. The cause of the lesions was unknown in two patients. In the other two symptoms had developed after head trauma and after anoxia. All lesions involved the internal segment of the GP. Two patients, including the patient with hemiparkinsonism, had additional involvement of the external segment of the GP. In the literature reports on 26 patients with bilateral lesions restricted to the GP only two with unilateral lesions were found. The patients with bilateral pallidal lesions manifested with dystonia, parkinsonism, or abulia. One of the patients with unilateral GP lesions had contralateral hemidystonia, the other contralateral arm tremor.
These cases emphasise the importance of the GP, particularly its internal segment, in the pathophysiology of dystonia.
基于基底神经节的生理学来阐释单侧苍白球病变后的临床特征。
对4例单侧苍白球（GP）病变患者进行临床检查，并回顾了有关苍白球病变患者的文献。
3例患者出现对侧肌张力障碍，其中1例主要局限于一只手臂，2例主要局限于一条腿。1例患者以对侧偏侧帕金森综合征为主，主要表现为小写症和一只手臂的轻度肌张力障碍。2例患者的病变原因不明。另外2例患者的症状分别在头部外伤和缺氧后出现。所有病变均累及苍白球内侧段。2例患者，包括患有偏侧帕金森综合征的患者，苍白球外侧段也有额外受累。在关于26例双侧病变仅限于苍白球的文献报道中，仅发现2例单侧病变患者。双侧苍白球病变患者表现为肌张力障碍、帕金森综合征或无动性缄默。1例单侧苍白球病变患者出现对侧偏侧肌张力障碍，另1例出现对侧手臂震颤。
这些病例强调了苍白球，尤其是其内侧段，在肌张力障碍病理生理学中的重要性。
