FitzGerald P M, Jankovic J
Department of Neurology, Baylor College of Medicine, Houston, Texas 77030.
Mov Disord. 1989;4(3):249-60. doi: 10.1002/mds.870040306.
We studied 10 patients with marked gait difficulty and no or only minimal upper limb involvement, defined here as lower body parkinsonism (LBP). They were compared to a control group of 100 patients with otherwise typical Parkinson's disease (PD). Both groups were of comparable age, but the mean duration of symptoms was significantly shorter in the LBP group (2.6 +/- 1.5 years versus 7.5 +/- 4.9 years). Gait disturbance was the initial symptom in 90% of LBP patients, as opposed to 7% of controls. Hypertension was present in 70% of LBP patients, and only 22% responded to levodopa. In contrast, only 21% of controls had a history of hypertension, and 96% improved with levodopa. We conclude that these 10 LBP patients constitute a homogenous group, distinct from typical PD. Besides their disproportionate gait disturbance, they are distinguished from PD patients by more rapid progression, higher incidence of hypertension, and a poor response to levodopa. Ischemic etiology for LBP is supported by abnormal neuroimaging studies.
我们研究了10例步态严重困难且无上肢受累或仅有轻微上肢受累的患者，在此将其定义为下体帕金森综合征（LBP）。将他们与100例患有典型帕金森病（PD）的对照组患者进行比较。两组年龄相当，但LBP组的平均症状持续时间明显较短（2.6±1.5年对7.5±4.9年）。90%的LBP患者步态障碍为首发症状，而对照组仅为7%。70%的LBP患者患有高血压，只有22%对左旋多巴有反应。相比之下，对照组只有21%有高血压病史，96%的患者使用左旋多巴后病情改善。我们得出结论，这10例LBP患者构成了一个与典型PD不同的同质群体。除了步态障碍不成比例外，他们与PD患者的区别还在于进展更快、高血压发病率更高以及对左旋多巴反应不佳。神经影像学研究异常支持LBP的缺血性病因。
