急诊科中的一个隐匿模仿者：急性药物性肌张力障碍病例报告
A subtle mimicker in emergency department: Illustrated case reports of acute drug-induced dystonia.
作者信息
Angelis Maria Vittoria De, Giacomo Roberta Di, Muzio Antonio Di, Onofrj Marco, Bonanni Laura
机构信息
Neurology Clinic (MVD, AD, RD,LB, MO), "SS Annunziata" Hospital Department of Neuroscience, Imaging and Clinical Sciences (RD, MO, LB) University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
出版信息
Medicine (Baltimore). 2016 Oct;95(41):e5137. doi: 10.1097/MD.0000000000005137.
BACKGROUND
Movement disorder emergencies include any movement disorder which develops over hours to days, in which failure to appropriately diagnose and manage can result in patient morbidity or mortality.Movement disorder emergencies include acute dystonia: sustained or intermittent muscle contractions causing abnormal, often repetitive, movements. Acute dystonia is a serious challenge for emergency room doctors and neurologists, because of the high probability of misdiagnosis, due to the presence of several mimickers including partial seizures, meningitis, localized tetanus, serum electrolyte level abnormalities, strychnine poisoning, angioedema, malingering, catatonia, and conversion.
METHODS
We describe 2 examples, accompanied by videos, of acute drug-induced oro-mandibular dystonia, both subsequent to occasional haloperidol intake.
RESULTS
Management and treatment of this movement disorder are often difficult: neuroleptics withdrawal, treatment with benzodiazepines, and anticholinergics are recommended.
CONCLUSION
Alternative treatment options are also discussed.
背景
运动障碍急症包括数小时至数天内出现的任何运动障碍，若未能进行恰当诊断和处理，可能导致患者发病或死亡。运动障碍急症包括急性肌张力障碍：持续或间歇性肌肉收缩，导致异常的、常为重复性的运动。急性肌张力障碍对急诊医生和神经科医生而言是一项严峻挑战，因为存在多种可与之混淆的病症，包括部分癫痫发作、脑膜炎、局限性破伤风、血清电解质水平异常、士的宁中毒、血管性水肿、诈病、紧张症和转换障碍，误诊可能性很高。
方法
我们描述2例急性药物性口下颌肌张力障碍的病例，并配有视频，这2例均在偶然服用氟哌啶醇后出现。
结果
这种运动障碍的管理和治疗往往很困难：建议停用抗精神病药物，使用苯二氮䓬类药物和抗胆碱能药物进行治疗。
结论
还讨论了其他治疗选择。
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