Movement Disorders Unit, Department of Neurology, Brotzu General Hospital, Cagliari, Italy.
Department of Neurology, Santa Maria University Hospital, Via Tristano di Joannuccio 1, 05100, Terni, Italy.
Curr Neurol Neurosci Rep. 2017 Jan;17(1):6. doi: 10.1007/s11910-017-0712-7.
A movement disorder emergency has been defined by Fahn and Frucht as "any neurological disorder evolving acutely or subacutely, in which the clinical presentation is dominated by a primary movement disorder, and in which failure to accurately diagnose and manage the patient may result in significant morbidity or even mortality." In this review, we discuss the most common situations in which hyperkinetic movement disorders, including chorea, ballism, dystonia, myoclonus, tics, as well as psychogenic disorders, can present as emergencies. Some acute hyperkinetic issues that can complicate Parkinson's disease and parkinsonism, such as the rare dyskinesia-hyperpyrexia syndrome, will be also covered. The phenomenology and natural history of medication-induced dystonic reaction, a common form of acute secondary dystonia frequently leading to emergency department consultations, are discussed in detail. Despite the acute nature, most of these conditions can result in a good outcome. Rare but serious disorders such as status dystonicus or malignant Gilles de la Tourette syndrome may lead to substantial morbidity and mortality. Thus, we emphasize the need to develop means for more accurate and prompt recognition and treatment of these syndromes.
运动障碍急症已由 Fahn 和 Frucht 定义为“任何神经系统疾病，其临床表现以原发性运动障碍为主，且在诊断和治疗患者方面的失败可能导致显著的发病率，甚至死亡率。” 在本次综述中，我们讨论了常见的以运动障碍为主要表现的急症情况，包括舞蹈症、投掷症、肌张力障碍、肌阵挛、抽动症以及心因性运动障碍。我们还将讨论一些可能使帕金森病和帕金森综合征复杂化的急性运动障碍问题，如罕见的运动障碍-高热综合征。本文详细讨论了药物诱导的肌张力障碍反应这种常见的急性继发性肌张力障碍，其是导致急诊科就诊的常见原因。尽管是急性发作，但大多数情况下这些疾病的预后较好。而一些罕见但严重的疾病，如肌张力障碍持续状态或恶性 Gilles de la Tourette 综合征，可能会导致严重的发病率和死亡率。因此，我们强调需要开发更准确和及时识别和治疗这些综合征的方法。
