Tsukahara Yuka, Suzuki Keisuke, Kokubun Norito, Nakamura Toshiki, Takekawa Hidehiro, Hirata Koichi
Department of Neurology, Dokkyo Medical University.
Rinsho Shinkeigaku. 2016 Aug 31;56(8):560-4. doi: 10.5692/clinicalneurol.cn-000894. Epub 2016 Jul 29.
A 74-year-old man was referred to our department for dizziness and progressive unsteady gait over 6 years. His family history was unremarkable. Neurological examination showed dysarthria, saccadic eye movement, palatal tremor (1.7 Hz)-synchronous with rotational ocular movement, and truncal ataxia. T2-weighted magnetic resonance imaging (MRI) of the brain revealed hyperintense and hypertrophic bilateral inferior olivary nuclei at the medulla and mild cerebellar atrophy. On the basis of neurological findings of oculopalatal tremor and cerebellar ataxia with brain MRI findings, the diagnosis of progressive ataxia and palatal tremor (PAPT) was made. PAPT should be included in differential diagnosis of dizziness observed in elderly individuals.
一名74岁男性因头晕和6年来逐渐加重的步态不稳被转诊至我科。他的家族史无异常。神经系统检查显示构音障碍、眼球跳动、与旋转性眼球运动同步的腭震颤（1.7Hz）以及躯干共济失调。脑部T2加权磁共振成像（MRI）显示延髓双侧下橄榄核高信号且肥大，以及轻度小脑萎缩。根据眼腭震颤和小脑共济失调的神经学表现以及脑部MRI结果，诊断为进行性共济失调和腭震颤（PAPT）。PAPT应纳入老年患者头晕的鉴别诊断中。
