Harper Adam, Bayliss Mark, Saha Romi, Scutt Amanda, Nisbet Angus
Brighton and Sussex University Hospitals NHS Trust-Academic Department of Medicine for Older People, Briggs Day Unit, Brighton General Hospital, Brighton BN2 3EW, UK.
Age Ageing. 2008 Nov;37(6):719-20. doi: 10.1093/ageing/afn216. Epub 2008 Oct 15.
A 79-year-old woman presented with dystonic posturing of the right leg while walking and an action tremor of her hands, both of which were levodopa responsive. She subsequently developed gait freezing. However, there was neither generalised bradykinesia nor rigidity. Structural imaging showed no significant changes, and a dopamine transporter scan was normal. She subsequently required rapidly escalating doses of levodopa in order to achieve symptom control, raising concerns over the possible development of a dopamine dysregulation syndrome. Issues raised included the difficulties of managing patients with a rare diagnosis and the role of dopaminergic medication with the potential for abuse.
一名79岁女性在行走时出现右腿肌张力障碍姿势,双手有动作性震颤,两者均对左旋多巴有反应。随后她出现步态冻结。然而,既没有全身性运动迟缓也没有强直。结构成像未显示明显变化,多巴胺转运体扫描正常。为了控制症状,她随后需要迅速增加左旋多巴剂量,这引发了对多巴胺调节障碍综合征可能发展的担忧。提出的问题包括管理罕见诊断患者的困难以及有滥用可能性的多巴胺能药物的作用。