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运动障碍与中风

Movement disorders and stroke.

作者信息

Defebvre L, Krystkowiak P

机构信息

Department of Neurology, Roger-Salengro Hospital, rue Émile-Laine, 59037 Lille, France.

Department of Neurology, hôpital Nord, 80054 Amiens cedex 01, France.

出版信息

Rev Neurol (Paris). 2016 Aug-Sep;172(8-9):483-487. doi: 10.1016/j.neurol.2016.07.006. Epub 2016 Jul 28.

Abstract

Stroke may be associated with different types of movement disorders, such as hyperkinetic syndromes (hemichorea-hemiballism, unilateral asterixis, limb-shaking, dystonia, tremor, myoclonus) and hypokinetic syndromes (especially vascular parkinsonism). However, movement disorders are rare and transient in acute stroke and, as a permanent consequence, are more often delayed. While ischemic and hemorrhagic strokes can happen at any level of the frontal-subcortical motor system, they can be explained most of the time by a dysfunction in the basal ganglia motor circuit. However, only brain MRI allows the involved structure(s) to be precisely located, and each syndrome is specific to the type of lesion. Treatment is above all symptomatic. Only limb-shaking syndrome requires urgent surgical treatment because of the low-perfusion hemodynamic state. The functional prognosis depends on the type of movement disorder.

摘要

中风可能与不同类型的运动障碍有关,如运动亢进综合征(偏侧舞蹈症-偏侧投掷症、单侧扑翼样震颤、肢体抖动、肌张力障碍、震颤、肌阵挛)和运动减退综合征(尤其是血管性帕金森综合征)。然而,运动障碍在急性中风中很少见且是短暂的,作为永久性后果则更常延迟出现。虽然缺血性和出血性中风可发生在额叶-皮质下运动系统的任何水平,但大多数情况下可由基底神经节运动回路功能障碍来解释。然而,只有脑部磁共振成像(MRI)才能精确确定受累结构,且每种综合征都特定于病变类型。治疗首先是对症治疗。只有肢体抖动综合征因低灌注血流动力学状态需要紧急手术治疗。功能预后取决于运动障碍的类型。

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