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良性肌束震颤与皮质类固醇使用:可能存在关联?最新进展。

Benign fasciculations and corticosteroid use: possible association? An update.

作者信息

Orsini Marco, Sztajnbok Flavio R, Oliveira Acary Bulle, Araújo Leite Marco Antonio, Júnior Salem Peter, de Freitas Marcos R G, Nascimento Osvaldo J M, Silva Júlio Guilherme, Sholer Marzia Puccioni, Guimarães Fernando Silva, Pereira Alessandra Cardoso, de Menezes Sara Lúcia Silveira, da Silva Catharino Antonio Marcos, Bino Fabrício

机构信息

Neurology Service - Antonio Pedro University Hospital - Federal Fluminense University - HUAP - UFF;

出版信息

Neurol Int. 2011 Jul 5;3(2):e11. doi: 10.4081/ni.2011.e11. Epub 2011 Sep 20.

Abstract

Fasciculations are characterized by visible subtle and fast contractions of muscle, even wormlike in movement, by the contraction of a fascicle of muscle fibers. The authors present the case study of a 28-year-old patient with the appearance of migratory and diffuse fasciculations with an onset after partial tapering off of oral corticosteroides (60 mg total dose) indicated for treatment of Minimal change Glomerulopathy. Clinical Neurological physical exam allied with an ENMG, besides other complementary laboratory exams were used for screening the above-mentioned patient. Afterwards, current research relating to the topic at hand was made in order to update the data available in the Bireme, Scielo and PubMed Data Banks using the following key words: Fasciculation's, motor neuron disease, and benign fasciculations in the Portuguese, English as well as Spanish language. Although fasciculation's are most commonly associated with Motor neuron disease as well as with certain metabolic disorders, they may also be present in individuals with absolutely no underlying pathological disorders. In our case, fasciculation potentials that have been present for six months, with no other signs of a neurogenic disorder as well as absence of laboratory findings, the patient received a diagnosis of Benign Fasciculation Syndrome (BFS).We believe that the use of corticosteroides in high doses with subsequent tapering contributed to the fasciculation's, especially due to the changes that this causes on the ionic channels. Fasciculation's are symptoms seen in a large range of conditions, and also being the main symptom of the so-called Benign Fasciculation Syndrome. We have presented an example of this clinical syndrome in a patient whose complaint was fasciculation's, with complete clinical remission of symptoms following complete tapering off of corticosteroid six months previously.

摘要

肌束震颤的特征是,一束肌纤维收缩致使肌肉出现可见的细微快速收缩,运动时甚至呈蠕虫样。作者报告了一例28岁患者的病例研究,该患者在口服用于治疗微小病变型肾病的皮质类固醇(总剂量60毫克)部分减量后,出现游走性和弥漫性肌束震颤。除其他补充实验室检查外,临床神经体格检查联合肌电图用于对上述患者进行筛查。之后,为更新Bireme、Scielo和PubMed数据库中的可用数据,使用葡萄牙语、英语和西班牙语的以下关键词对当前相关主题研究进行了检索:肌束震颤、运动神经元病和良性肌束震颤。虽然肌束震颤最常与运动神经元病以及某些代谢紊乱相关,但也可能出现在没有潜在病理疾病的个体中。在我们的病例中,肌束震颤电位已存在6个月,没有其他神经源性疾病迹象且实验室检查无异常,该患者被诊断为良性肌束震颤综合征(BFS)。我们认为,高剂量使用皮质类固醇随后减量导致了肌束震颤,特别是由于这会引起离子通道的变化。肌束震颤是在多种情况下出现的症状,也是所谓良性肌束震颤综合征的主要症状。我们展示了这一临床综合征在一名以肌束震颤为主诉的患者中的例子,在6个月前完全停用皮质类固醇后症状完全临床缓解。

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