Mrabet Khiari H, Masmoudi S, Mrabet A
Service de neurologie, établissement public de santé Charles-Nicolle, boulevard 9-Avril, 1006 Tunis, Tunisie.
Rev Neurol (Paris). 2009 May;165(5):489-92. doi: 10.1016/j.neurol.2008.08.003. Epub 2008 Oct 18.
Parry-Romberg syndrome is a rare entity of unknown etiology, characterized by hemifacial or hemibody atrophy affecting subcutaneous tissues. Its main clinical manifestations are neurological, ocular and dermatological. Paroxysmal kinesigenic dyskinesia (PKD) is characterized by brief episodes of choreic/dystonic movements triggered by sudden movements and improved by antiepileptic drugs particularly carbamazepine. It can be sporadic or familial with an autosomal dominant inheritance. Little is known about the pathophysiology of PKD, although a channelopathy is thought likely. The association of these two diseases is rare.
Over three years, a 42-year-old patient progressively developed left hemiatrophy. Since age 14, he presented paroxysmal dystonic disorders of the limbs triggered by sudden movements and controlled by carbamazepine. The diagnosis of PKD associated with Parry-Romberg syndrome was established. Investigations revealed immunologic and diffuse electrophysiological abnormalities (EEG and EMG).
PKD associated with Parry-Romberg syndrome is very rare but does not appear to be fortuitous. It suggests a common mechanism via an underlying channelopathy or dysimmune disorder.
帕里-罗姆伯格综合征是一种病因不明的罕见疾病,其特征为影响皮下组织的半侧面部或半身萎缩。其主要临床表现为神经、眼部和皮肤方面的症状。发作性运动诱发性运动障碍(PKD)的特点是由突然运动引发的短暂舞蹈样/肌张力障碍性运动发作,并可通过抗癫痫药物尤其是卡马西平得到改善。它可以是散发性的,也可以是具有常染色体显性遗传的家族性疾病。尽管认为可能存在离子通道病,但对PKD的病理生理学知之甚少。这两种疾病的关联很罕见。
在三年多的时间里,一名42岁患者逐渐出现左侧萎缩。自14岁起,他就出现了由突然运动引发的肢体发作性肌张力障碍性疾病,并由卡马西平控制。确诊为与帕里-罗姆伯格综合征相关的PKD。检查发现免疫和弥漫性电生理异常(脑电图和肌电图)。
与帕里-罗姆伯格综合征相关的PKD非常罕见,但似乎并非偶然。这提示可能存在一种通过潜在离子通道病或免疫功能紊乱的共同机制。