成人史咽峡炎后帕金森病的体征和症状。
Parkinsonian signs and symptoms in adults with a history of Sydenham's chorea.
机构信息
Movement Disorders Clinic, Neurology Service, Department of internal Medicine, Universidade Federal de Minas Gerais, Av Pasteur 89/1107, 30150-290 Belo Horizonte MG, Brazil.
出版信息
Parkinsonism Relat Disord. 2012 Jun;18(5):595-7. doi: 10.1016/j.parkreldis.2011.11.002. Epub 2011 Nov 21.
BACKGROUND
Sydenham's chorea is associated with dysfunction of fronto-striatal circuits induced by cross-reactive antibodies to group A β-hemolytic streptococcus. High susceptibility of extrapyramidal effects of neuroleptics in patients with Sydenham's chorea suggests underlying nigro-striatal dysfunction.
OBJECTIVE
To study the presence of parkinsonism in patients with a history of Sydenham's Chorea.
METHODS
We used the UFMG Sydenham's Chorea Rating Scale (USCRS) and the Unified Parkinson's Disease Rating Scale (UPDRS) part III, respectively, to determine the presence of chorea and parkinsonian symptoms and signs in 25 adults with a history of previous Sydenham's Chorea currently without chorea or use of anti-choreic drugs.
RESULTS
Bradykinesia was found in 64% of subjects. There was a statistically significant correlation between bradykinesia and hemichorea (-0.412; p = 0.036) and bradykinesia and generalized chorea (0.412; p = 0.036). There was no correlation between bradykinesia and use of anti-choreic drugs.
CONCLUSIONS
Bradykinesia is common in patients with Sydenham's Chorea in remission. This finding suggests an immune-mediated dysfunction of the nigro-striatal system.
背景
风湿性舞蹈病与 A 组β溶血性链球菌交叉反应抗体引起的额纹状体回路功能障碍有关。神经安定剂引发的锥体外系副作用在风湿性舞蹈病患者中易感性高，表明黑质纹状体功能障碍。
目的
研究有风湿性舞蹈病史患者是否存在帕金森病。
方法
我们分别使用 UFMG 风湿性舞蹈病评分量表（USCRS）和统一帕金森病评定量表（UPDRS）第 3 部分，来确定 25 名以前患有风湿性舞蹈病且目前无舞蹈病或使用抗舞蹈病药物的成年人是否存在帕金森病症状和体征。
结果
64%的受试者存在运动迟缓。运动迟缓与偏侧舞蹈症（-0.412;p=0.036）和全身性舞蹈症（0.412;p=0.036）之间存在统计学显著相关性。运动迟缓与使用抗舞蹈病药物之间无相关性。
结论
缓解期风湿性舞蹈病患者常见运动迟缓。这一发现提示黑质纹状体系统存在免疫介导的功能障碍。
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