Nuclear Medicine, Sanjay Gandhi Post Graduate Medical Sciences, Lucknow, India.
J Neurol Sci. 2011 May 15;304(1-2):107-10. doi: 10.1016/j.jns.2011.02.001. Epub 2011 Mar 13.
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.
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。
