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[一系列被诊断为患有进行性核上性麻痹患者的临床与流行病学描述]

[A clinical and epidemiological description of a series of patients diagnosed as suffering from progressive supranuclear palsy].

作者信息

Alvarez-González E, Maragoto-Rizo C, Arteche-Prior M, Pérez-Parra S, Carballo M, Alvarez-González L

机构信息

Centro Internacional de Restauración Neurologíca (CIREN), Ciudad de La Habana, Cuba.

出版信息

Rev Neurol. 2004;39(11):1006-10.

Abstract

INTRODUCTION

Progressive supranuclear palsy is a disease that normally presents only sporadically in adults and courses in a progressive, chronic manner. It is characterised by the presence of supranuclear ophthalmoplegia, postural instability, a Parkinsonian syndrome, pseudobulbar affect, cervical dystonia and cognitive impairment.

PATIENTS AND METHODS

We conducted a descriptive study of clinical and epidemiological features in a series of 18 patients who satisfied the mandatory NINDS-SPSP clinical eligibility criteria for the likely diagnosis of progressive supranuclear palsy, using the scale developed by Golbe et al.

RESULTS AND CONCLUSIONS

The mean age of onset of the disease was 58.6 +/- 8.2 years, 55.5% of the patients were males, the average history of the disease at the time of diagnosis was 4.39 +/- 2.3 years, and there was a diagnostic subregister in the first 4 years of the disease. Gait disorders, falls and slowness were the most frequently observed presenting forms of the disease. During their first four years with the disease, 75% of the patients were totally independent when it came to carrying out activities of daily living, whereas after the fourth year there was a predominance of the need for aid and absolute dependence. Dysphagia was more frequent in the later stages of the disease. Ocular motility disorders and impaired cognitive functioning were obvious in the initial stages of the disease, and there was a strong correlation between the length of time the disease had been coursing and the severity of the ocular and cognitive disorders.

摘要

引言

进行性核上性麻痹是一种通常仅在成人中散发性出现且呈进行性、慢性病程的疾病。其特征为存在核上性眼肌麻痹、姿势不稳、帕金森综合征、假性球麻痹、颈部肌张力障碍和认知障碍。

患者与方法

我们对18例符合美国国立神经疾病与中风研究所 - 进行性核上性麻痹临床诊断标准的患者进行了临床和流行病学特征的描述性研究,采用了戈尔贝等人制定的量表。

结果与结论

该疾病的平均发病年龄为58.6±8.2岁,55.5%的患者为男性,诊断时疾病的平均病程为4.39±2.3年,且在疾病的前4年有一个诊断亚登记。步态障碍、跌倒和动作迟缓是该疾病最常观察到的表现形式。在患病的前四年中,75%的患者在进行日常生活活动时完全独立,而在第四年后,需要帮助和完全依赖的情况占主导。吞咽困难在疾病后期更为常见。眼动障碍和认知功能受损在疾病初期较为明显,且疾病病程长短与眼部和认知障碍的严重程度之间存在很强的相关性。

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