Nakawah Mohammad Obadah, Lai Eugene C
Stanely H. Appel, Department of Neurology, Houston Methodist Neurological Institute, Houston, TX, USA.
Neuropsychiatr Dis Treat. 2016 Nov 7;12:2885-2893. doi: 10.2147/NDT.S118347. eCollection 2016.
Strokes, whether ischemic or hemorrhagic, are among the most common causes of secondary movement disorders in elderly patients. Stroke-related (vascular) movement disorders, however, are uncommon complications of this relatively common disease. The spectrum of post-stroke movement disorders is broad and includes both hypo- and hyperkinetic syndromes. Post-stroke dyskinesias are involuntary hyperkinetic movements arising from cerebrovascular insults and often present with mixed phenotypes of hyperkinesia which can sometimes be difficult to classify. Nevertheless, identification of the most relevant motor phenotype, whenever possible, allows for a more specific phenomenological categorization of the dyskinesia and thus helps guide its treatment. Fortunately, post-stroke dyskinesias are usually self-limiting and resolve within 6 to 12 months of onset, but a short-term pharmacotherapy might sometimes be required for symptom control. Functional neurosurgical interventions targeting the motor thalamus or globus pallidus interna might be considered for patients with severe, disabling, and persistent dyskinesias (arbitrarily defined as duration longer than 12 months).
中风，无论是缺血性还是出血性，都是老年患者继发性运动障碍的最常见原因之一。然而，与中风相关的（血管性）运动障碍是这种相对常见疾病的罕见并发症。中风后运动障碍的范围很广，包括运动减少和运动增多综合征。中风后运动障碍是由脑血管损伤引起的非自主性运动增多，通常表现为运动增多的混合表型，有时难以分类。尽管如此，尽可能识别最相关的运动表型有助于对运动障碍进行更具体的现象学分类，从而有助于指导其治疗。幸运的是，中风后运动障碍通常是自限性的，在发病后6至12个月内会自行缓解，但有时可能需要短期药物治疗来控制症状。对于严重、致残且持续的运动障碍（任意定义为持续时间超过12个月）患者，可考虑针对运动丘脑或内侧苍白球的功能性神经外科干预。
