左乙拉西坦治疗多发性硬化症伴阵发性共济失调和构音障碍的疗效观察。
Successful treatment of paroxysmal ataxia and dysarthria in multiple sclerosis with levetiracetam.
机构信息
Department of Neurology, University of Minnesota Medical School, Minneapolis, MN, United States; Brain Sciences Center, VA Medical Center, Minneapolis, MN, United States.
Department of Neurology, University of Minnesota Medical School, Minneapolis, MN, United States; Brain Sciences Center, VA Medical Center, Minneapolis, MN, United States.
出版信息
Mult Scler Relat Disord. 2016 Nov;10:79-81. doi: 10.1016/j.msard.2016.09.003. Epub 2016 Sep 9.
BACKGROUND
Paroxysmal ataxia and dysarthria (PAD) is a relatively rare symptom in Multiple Sclerosis patients. PAD involves transient dysfunction in control, coordination and initiation of speech and/or limb movements.
OBJECTIVE
To describe the successful use of levetiracetam for the treatment of PAD.
METHODS
Case report.
RESULTS
A 37-year-old woman with MS developed PAD approximately 3 months after a multifocal MS relapse. Brain MRI showed a lesion in the posterior aspect of the midbrain as well as in the right posterior internal capsule, both of which were adjacent to the red nucleus. Attack frequency was reduced after starting levetiracetam at a dose of 500mg twice daily, and attacks stopped completely once the dose was increased to 750mg twice daily.
CONCLUSIONS
Given its advantages (in terms of side effects, safety profile and ease of use compared to other anticonvulsants), we suggest that levetiracetam be considered for management of PAD, and perhaps for other paroxysmal MS symptoms as well.
背景
发作性共济失调和构音障碍（PAD）是多发性硬化症患者相对罕见的症状。PAD 涉及言语和/或肢体运动的控制、协调和启动的短暂性功能障碍。
目的
描述左乙拉西坦治疗 PAD 的成功应用。
方法
病例报告。
结果
一名 37 岁女性，患有 MS，在多发 MS 复发后约 3 个月出现 PAD。脑 MRI 显示中脑后部和右侧后内囊均有病变，均紧邻红核。每日两次起始剂量为 500mg 的左乙拉西坦治疗后，发作频率降低，每日两次增加至 750mg 时发作完全停止。
结论
鉴于其优势（与其他抗惊厥药相比，在副作用、安全性和易用性方面），我们建议考虑使用左乙拉西坦来管理 PAD，也可能用于治疗其他发作性 MS 症状。
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