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[进行性肌肉萎缩。肌萎缩侧索硬化症一种罕见的诊断变异型]

[Progressive muscle atrophy. A rarely diagnosed variant of amyotrophic lateral sclerosis].

作者信息

Meyer T, Münch C, van Landeghem F K H, Borisow N, Dullinger J, Linke P

机构信息

Neurologische Klinik und Poliklinik, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, Germany.

出版信息

Nervenarzt. 2007 Dec;78(12):1383-8. doi: 10.1007/s00115-007-2288-y.

Abstract

Progressive muscle atrophy (PMA) is a degenerative disease of the lower motor neuron. The course of the illness and the fatal prognosis correspond to those of amyotrophic lateral sclerosis (ALS). Neuropathologic and genetic findings support categorizing PMA within the spectrum of ALS, even though no clinical sign of a disorder of the upper motor neuron is demonstrable. The diagnosis of PMA is based on advanced extremity pareses and atrophies with a high progression rate. Respiratory insufficiency is determinative of the prognosis. Absent or late affection of bulbar functions is characteristic of the disease. Intraneuronal bunina bodies and ubiquitine-positive inclusions, which are established morphologic characteristics of ALS, are found post mortem. The treatment options of riluzol medication, respiratory therapy, and nutrition are analogous to those for typical ALS.

摘要

进行性肌肉萎缩(PMA)是一种下运动神经元的退行性疾病。其病程和致命预后与肌萎缩侧索硬化症(ALS)相似。神经病理学和遗传学研究结果支持将PMA归类于ALS谱系内,尽管未发现上运动神经元功能障碍的临床体征。PMA的诊断基于晚期肢体轻瘫和萎缩,且进展速度较快。呼吸功能不全决定预后。球部功能未受累或受累较晚是该疾病的特征。死后尸检可发现神经元内布尼亚小体和泛素阳性包涵体,这些是ALS的典型形态学特征。利鲁唑药物治疗、呼吸治疗和营养支持等治疗方法与典型ALS的治疗方法类似。

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