Department of Neurology, University of Munich, Munich, Germany.
Mult Scler. 2013 Apr;19(4):506-8. doi: 10.1177/1352458512461394. Epub 2012 Oct 15.
The reversible potassium channel blocker 4-aminopyridine is effective in the treatment of numerous cerebellar dysfunctions, such as episodic ataxia type 2 and downbeat nystagmus syndrome. In 2011, its sustained release form, dalfampridine, was admitted in Europe for the treatment of walking difficulties in patients with multiple sclerosis (MS). Here we report the case of a 44-year old patient with a progressive MS whose upper limb tremor was markedly reduced under treatment with 4-aminopyridine, as documented in a Tremor Activities of Daily Living questionnaire and in the 9-Hole Peg test. Hand accelerations decreased in the left hand from 10.9 m/sec(2) to 2.2 m/sec(2) and in the right hand from 4.2 m/sec(2) to 0.9 m/sec(2). This case report indicates for the first time that 4-aminopyridine might be effective in the symptomatic treatment of tremor entities in patients with MS. The finding calls for further prospective studies to determine the usefulness of 4-aminopyridine or its sustained-release form dalfampridine in treating patients with tremor and MS.
可逆钾通道阻滞剂 4-氨基吡啶对治疗多种小脑功能障碍（如发作性共济失调 2 型和下跳性眼球震颤综合征）有效。2011 年，其缓释形式地拉普利定在欧洲被批准用于治疗多发性硬化症（MS）患者的行走困难。在这里，我们报告了一例 44 岁的进行性 MS 患者，在接受 4-氨基吡啶治疗后，其上肢震颤明显减轻，震颤日常生活活动问卷和 9 孔钉测试均有记录。左手加速从 10.9 m/sec(2)降低至 2.2 m/sec(2)，右手从 4.2 m/sec(2)降低至 0.9 m/sec(2)。本病例报告首次表明 4-氨基吡啶可能对 MS 患者的震颤症状治疗有效。这一发现需要进一步的前瞻性研究来确定 4-氨基吡啶或其缓释形式地拉普利定治疗震颤和 MS 患者的有效性。
