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儿童肌阵挛性脑病(作者译)

[Myoclonic encephalopathy in childhood (author's transl)].

作者信息

Heyer R, Hamann J, Offner G, Uebbing G

出版信息

Monatsschr Kinderheilkd (1902). 1977 Jun;125(6):640-5.

PMID:196187
Abstract

Two new cases of infantile myoclonic encephalopathy are reported and a survey of literature is given. The disease is characterized by generalised myoclonic jerks in all striated muscles, by cerebellar ataxia and by fast, jerking, mostly conjugated irregular eye movements (opsoclonus). The disease develops mostly during late infancy and early childhood. The pathogenesis is unknown, probably it is caused by immunological reactions to various agents. Treatment with ACTH or corticosteroids leads to rapid remission of the initial neurological symptoms, but it is suggested that therapy does not prevent frequent sequelae of psychomotor retardation and speech distubances. Remarkably, there is the high coincidence of infantile myoclonic encephalopathy and neuroblastoma. Therefore it is necessary to keep in mind the possibility of a causative neuroblastoma in all children with myoclonic encephalopathy and to control repeatly radiological findings and urin-excretion of catecholamines as well as their metabolic products.

摘要

报告了两例婴儿肌阵挛性脑病的新病例,并对文献进行了综述。该疾病的特征是所有横纹肌出现全身性肌阵挛抽搐、小脑共济失调以及快速、抽搐性、大多为共轭性的不规则眼球运动(眼阵挛)。该疾病大多在婴儿晚期和儿童早期发病。发病机制尚不清楚,可能是由对各种因素的免疫反应引起的。使用促肾上腺皮质激素(ACTH)或皮质类固醇治疗可使最初的神经症状迅速缓解,但有人认为该疗法不能预防精神运动发育迟缓及言语障碍等常见后遗症。值得注意的是,婴儿肌阵挛性脑病与神经母细胞瘤高度相关。因此,对于所有患有肌阵挛性脑病的儿童,有必要牢记存在致病神经母细胞瘤的可能性,并反复检查影像学结果、儿茶酚胺及其代谢产物的尿排泄情况。

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