鉴别特发性震颤与帕金森病：床旁检查与实验室评估。
Distinguishing essential tremor from Parkinson's disease: bedside tests and laboratory evaluations.
机构信息
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
出版信息
Expert Rev Neurother. 2012 Jun;12(6):687-96. doi: 10.1586/ern.12.49.
Abstract
Distinguishing essential tremor from Parkinson's disease can be challenging, both in the early stages of these diseases and as these diseases progress. Various tremor types (rest, postural, kinetic and intention) may be seen in both essential tremor and Parkinson's disease. Furthermore, with time, the two diseases may coexist within a single patient. Detailed clinical examination with attention to specific features of tremor (frequency, amplitude, pattern and distribution) and associated neurological findings may help distinguish patients with the two diseases. Laboratory testing may provide information that further aids in differentiating the two diseases. These tests include accelerometry and surface electromyography, spiral analysis, dopamine transporter imaging, olfactory testing and, eventually, postmortem histopathology. These tests have limitations and their diagnostic utility requires additional study.
摘要
区分特发性震颤和帕金森病具有挑战性，无论是在这两种疾病的早期阶段，还是随着疾病的进展。特发性震颤和帕金森病均可出现各种震颤类型（静止性、姿势性、意向性和运动性）。此外，随着时间的推移，两种疾病可能会在同一患者中共存。详细的临床检查，注意震颤（频率、幅度、模式和分布）和相关神经学发现的特定特征，可能有助于区分这两种疾病的患者。实验室检查可能提供有助于区分这两种疾病的信息。这些检查包括加速计和表面肌电图、螺旋分析、多巴胺转运蛋白成像、嗅觉测试，最终还包括尸检组织病理学检查。这些检查有局限性，其诊断效用需要进一步研究。
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