Munhoz Renato P, Scorr Laura M, Factor Stewart A
aMorton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada bDepartment of Neurology, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.
Curr Opin Neurol. 2015 Aug;28(4):406-12. doi: 10.1097/WCO.0000000000000212.
Although movement disorders are traditionally viewed as chronic diseases that are followed electively, a growing number of these patients present with acute, severe syndromes or complications of their underlying neurological problem. Identifying and managing movement disorders emergencies is challenging, even for the specialist. This review summarizes evidence outlining the clinical presentation of acute, life-threatening movement disorders.
We review the most significant aspects in the most common movement disorders emergencies, including acute complications related to Parkinson's disease and parkinsonism, serotonergic, and neuroleptic malignant syndromes, chorea, ballismus, dystonia, myoclonus, and tics.
The increasing amount of information delineating the descriptions of movement disorders emergencies provides means for more effective prevention, identification, and management for the nonspecialist. Although the commonest of these syndromes eventually have a good outcome, serious conditions such as neuroleptic malignant syndrome and status dystonicus may induce substantial rates of morbidity and mortality. This review re-emphasizes the need for their prompt identification and management.
尽管运动障碍传统上被视为需择期随访的慢性疾病,但越来越多的此类患者出现急性、严重综合征或其潜在神经问题的并发症。即便对于专科医生而言,识别和处理运动障碍急症也颇具挑战性。本综述总结了有关急性、危及生命的运动障碍临床表现的证据。
我们回顾了最常见的运动障碍急症中最重要的方面,包括与帕金森病和帕金森综合征、5-羟色胺能及抗精神病药物恶性综合征、舞蹈症、投掷症、肌张力障碍、肌阵挛和抽动相关的急性并发症。
描述运动障碍急症的信息日益增多,为非专科医生提供了更有效的预防、识别和处理方法。尽管这些综合征中最常见的最终预后良好,但诸如抗精神病药物恶性综合征和张力障碍状态等严重情况可能导致较高的发病率和死亡率。本综述再次强调了对其进行及时识别和处理的必要性。