Gekht A B, Polunina A G, Briun E A, Gusev E I
Zh Nevrol Psikhiatr Im S S Korsakova. 2003;103(2):9-15.
Neurological examination was performed in 79 heroin addicts (mean age 24.4 +/- 6.3 years; heroin abusing duration 16.6 +/- 12.4 months; heroin dose per day 0.48 +/- 0.42 grams). During the first week after withdrawal, "physical dependency" symptoms, mild hypomimia and hypokinesia, low muscle tone, low tendon reflexes and facilitated nociceptive reflexes were observed in more than 70% of the patients. Non-specific microneurological signs as nystagm, limited convergence, tremor and dynamic ataxia etc, were found in more than 35% of the cases. Previously reported meningeal irritation or polyneuropathy symptoms were not determined in the patients population. Most of the symptoms disappeared after 10 days of abstinence as the follow-up examination of the 34 patients revealed. Mild hypomimia and hypokinesia persisted along with characteristic psychopathological changes. The most abundant neurological disturbances were observed in patients abusing heroin for more than 6 months in dosages more than 0.4 grams per day. Heroin withdrawal symptoms include reversible decrease in muscle tone and tendon reflexes as well as facilitation of nociceptive reflexes and reversible non-specific neurological microsigns. Heroin encephalopathy is characterized by ventral striatum insufficiency signs.
对79名海洛因成瘾者进行了神经学检查(平均年龄24.4±6.3岁;海洛因滥用时长16.6±12.4个月;每日海洛因剂量0.48±0.42克)。在戒断后的第一周,超过70%的患者出现了“身体依赖”症状、轻度表情减少和运动迟缓、肌张力降低、腱反射减弱以及伤害性反射亢进。超过35%的病例出现了眼球震颤、集合受限、震颤和动态共济失调等非特异性微神经学体征。在患者群体中未发现先前报道的脑膜刺激或多发性神经病症状。对34名患者的随访检查显示,大多数症状在禁欲10天后消失。轻度表情减少和运动迟缓以及特征性精神病理变化持续存在。在每日滥用海洛因超过6个月且剂量超过0.4克的患者中观察到最严重的神经功能障碍。海洛因戒断症状包括肌张力和腱反射的可逆性降低、伤害性反射亢进以及可逆性非特异性神经微体征。海洛因脑病的特征是腹侧纹状体功能不全体征。