脑炎导致的口下颌肌张力障碍。

Oromandibular dystonia in encephalitis.

机构信息

Nuclear Medicine, Sanjay Gandhi Post Graduate Medical Sciences, Lucknow, India.

出版信息

J Neurol Sci. 2011 May 15;304(1-2):107-10. doi: 10.1016/j.jns.2011.02.001. Epub 2011 Mar 13.

DOI:10.1016/j.jns.2011.02.001

Abstract

We report clinical and MRI findings of 17 patients with oromandibular dystonia (OMD) due to Japanese encephalitis (14) and nonspecific encephalitis (3). Their median age was 14(2-53) years and 9 were females. 8 patients had jaw open and 9 jaw close OMD. The severity ranged between 2 and 4 on a 0-4 scale, 11 patients were anarthric and needed tube feeding. Cranial MRI was abnormal in 13 patients; the abnormalities were in thalamus in 9, substantia nigra in 10, caudate in 3, globus pallidus and putamen in 2 each and pons in 1 patient. SPECT revealed hypoperfusion in thalamus in 4, basal ganglia in 1, frontal in 6, parietal in 3 and temporal in 1 patient. By 6 months, OMD regressed completely in 6, by 1 grade in 2 and remained unchanged in 7 patients. OMD in encephalitis is mainly due to JE and half of these patients improve.

摘要

我们报告了 17 例由日本脑炎（14 例）和非特异性脑炎（3 例）引起的口颌肌张力障碍（OMD）患者的临床和 MRI 发现。他们的中位年龄为 14 岁（2-53 岁），其中 9 例为女性。8 例为张口型 OMD，9 例为闭口型 OMD。严重程度在 0-4 分之间为 2-4 分，11 例患者无言语能力，需要进行管饲。13 例患者的颅 MRI 异常；9 例异常位于丘脑，10 例异常位于黑质，3 例异常位于尾状核，2 例异常位于苍白球和壳核，1 例异常位于脑桥。SPECT 显示 4 例患者丘脑灌注减少，1 例患者基底节灌注减少，6 例患者额叶灌注减少，3 例患者顶叶灌注减少，1 例患者颞叶灌注减少。6 个月时，6 例 OMD 完全消退，2 例 OMD 改善 1 级，7 例 OMD 无变化。脑炎引起的 OMD 主要由 JE 引起，其中一半患者有所改善。