Armstrong Amy E, Gillan Eileen, DiMario Francis Joseph
1University of Connecticut School of Medicine, Farmington, CT, USA.
J Child Neurol. 2014 Mar;29(3):336-41. doi: 10.1177/0883073812474843. Epub 2013 Jan 29.
SMART syndrome (stroke-like migraine attacks after radiation therapy) is a rare condition that involves complex migraines with focal neurologic findings in patients following cranial irradiation for central nervous system malignancies. Little is known about the mechanisms behind the disorder, making successful treatment challenging. We report 2 new cases of SMART syndrome in pediatric patients as well as review all documented cases of the syndrome. Each of our 2 pediatric patients suffered multiple episodes. Attacks were characterized by severe headache, visual disturbance, aphasia, and weakness. Recovery occurred over several days to weeks. The data from all documented reports of SMART syndrome indicate a greater prevalence for male gender. An age-dependent pattern of onset was also observed, with a greater variability of syndrome onset in patients who received cranial irradiation at a younger age. SMART appears to be a reversible, recurrent long-term complication of radiation therapy with possible age- and gender-related influences.
SMART综合征（放疗后类似中风的偏头痛发作）是一种罕见病症，见于中枢神经系统恶性肿瘤接受颅脑照射后的患者，表现为伴有局灶性神经学体征的复杂性偏头痛。对于该病症背后的机制知之甚少，这使得成功治疗颇具挑战。我们报告2例小儿SMART综合征新病例，并对该综合征所有已记录的病例进行综述。我们的2例小儿患者均经历了多次发作。发作的特点为严重头痛、视觉障碍、失语和无力。恢复过程持续数天至数周。所有已记录的SMART综合征报告数据表明男性患病率更高。还观察到发病存在年龄依赖性模式，在较年轻接受颅脑照射的患者中综合征发病的变异性更大。SMART似乎是放疗的一种可逆性、复发性长期并发症，可能受年龄和性别的影响。
