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姿势性和运动性震颤患者的炎性肌病。

Inflammatory myopathy in a patient with postural and kinetik tremor.

机构信息

Department of Neuroscience, Neurological Clinic, University of Pisa, Via Roma 67, Pisa, Italy.

出版信息

Neurol Sci. 2011 Dec;32(6):1175-8. doi: 10.1007/s10072-011-0615-3. Epub 2011 May 10.

Abstract

Essential tremor (ET) is a common neurological disease of unknown etiopathogenesis, possibly neurodegenerative, characterized by kinetic tremor at the arms. Here we reported the case of an HCV-positive patient with inflammatory myopathy, who did not develop typical neuromuscular signs or symptoms during at least 7 years of hyperCKemia, in whom kinetic tremor of the arms was the prominent clinical feature, suggesting a possible diagnosis of ET. After 3 months of treatment with corticosteroids/methotrexate, creatine kinase (CK) levels were nearly normal and the tremor was remarkably improved. To our knowledge, similar cases have not been previously reported. Postural tremor can be present in muscular diseases, but only very rarely tremor has been reported as a major clinical feature. Because inflammatory myopathies are potentially treatable conditions it is very important to consider this diagnosis. Our case suggests that in patients with isolated postural and kinetic tremor routine laboratory assays should include CK blood screening.

摘要

特发性震颤(ET)是一种常见的神经系统疾病,病因不明,可能是神经退行性疾病,其特征是手臂的运动性震颤。在这里,我们报告了一例 HCV 阳性的炎性肌病患者,该患者在至少 7 年的高肌酸激酶血症期间没有出现典型的神经肌肉体征或症状,其手臂的运动性震颤是突出的临床特征,提示可能诊断为 ET。在接受皮质类固醇/甲氨蝶呤治疗 3 个月后,肌酸激酶(CK)水平几乎恢复正常,震颤明显改善。据我们所知,以前没有报道过类似的病例。姿势性震颤可能存在于肌肉疾病中,但只有极少数报道称震颤是主要的临床特征。由于炎性肌病是一种潜在可治疗的疾病,因此非常重要的是要考虑到这种诊断。我们的病例表明,对于仅出现姿势性和运动性震颤的患者,常规实验室检查应包括 CK 血液筛查。

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