Romero-López J, Moreno-Carretero M J, Escriche-Jaime D, Corredera-García E
Complejo Hospitalario Universitario de Vigo, Vigo, España.
Rev Neurol. 2008;47(12):638-40.
The rapid-onset dystonia-parkinsonism is a movement disorder which associates dystonic symptoms, especially those affecting orofacial muscles, and parkinsonian symptoms. All these symptoms start suddenly and then they stabilize along the process. This disorder usually occurs to young adults and is an autosomal dominant trait with a reduced penetrance, although some sporadic cases have been reported. The genetic alteration is found on the chromosome 19q13, where the mutated gene ATP1A3 has been identified. This gene is linked to the regulation of the sodium-potassium pump.
A 16-year-old woman developed a sudden onset of dystonic symptoms which affected her higher and lower limbs, bulbar muscles, together with severe dysarthria and dysphagia. The onset occurred over hours, but her symptoms have been stabilized for years. No movement or other neurological disorders are reported in her family history.
This is probably a sporadic case of rapid-onset dystonia-parkinsonism, and it is the second one reported in Spain. Diagnostic criteria, differential diagnosis, etiopahogenesis and genetic alterations are also discussed.
快速起病的肌张力障碍-帕金森综合征是一种运动障碍疾病,伴有肌张力障碍症状,尤其是影响口面部肌肉的症状以及帕金森症状。所有这些症状均突然起病,随后在病程中趋于稳定。这种疾病通常发生于年轻人,是一种常染色体显性遗传特征,外显率降低,不过也有一些散发病例的报道。基因改变位于19号染色体长臂1区3带,已鉴定出突变基因ATP1A3。该基因与钠钾泵的调节有关。
一名16岁女性突然出现肌张力障碍症状,累及上下肢、延髓肌,伴有严重构音障碍和吞咽困难。症状在数小时内出现,但已稳定多年。家族史中未报告有运动或其他神经系统疾病。
这可能是一例快速起病的肌张力障碍-帕金森综合征散发病例,是西班牙报告的第二例。还讨论了诊断标准、鉴别诊断、病因及基因改变。