肝豆状核变性神经系统症状的对症治疗。

Symptomatic treatment of neurologic symptoms in Wilson disease.

作者信息

Litwin Tomasz, Dušek Petr, Członkowska Anna

机构信息

Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.

Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, First Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic; Institute of Neuroradiology, University Medicine Goettingen, Goettingen, Germany.

出版信息

Handb Clin Neurol. 2017;142:211-223. doi: 10.1016/B978-0-444-63625-6.00018-5.

Abstract

Wilson disease (WD) is a potentially treatable neurodegenerative disorder. In the majority of cases, treatment with drugs that induce a negative copper balance (usually chelators or zinc salts) leads to improvements in liver function and neurologic signs. However, some patients show severe neurologic symptoms at diagnosis, such as tremor, dystonia, parkinsonism, and chorea. In this patient group, some neurologic deficits may persist despite adequate treatment, and further neurologic deterioration may be observed after treatment initiation. Such patients may require additional treatment to alleviate neurologic symptoms. Apart from general recommendations for WD anticopper treatment, there are currently no guidelines for managing neurologic symptoms in WD. The aim of this chapter is to summarize possible treatments of neurologic symptoms in WD based on the presently available medical literature.

摘要

威尔逊病(WD)是一种潜在可治疗的神经退行性疾病。在大多数情况下,使用诱导负铜平衡的药物(通常是螯合剂或锌盐)进行治疗可改善肝功能和神经症状。然而,一些患者在诊断时表现出严重的神经症状,如震颤、肌张力障碍、帕金森综合征和舞蹈症。在这一患者群体中,尽管进行了充分治疗,一些神经功能缺损可能仍然存在,并且在开始治疗后可能会观察到神经功能进一步恶化。这类患者可能需要额外的治疗来缓解神经症状。除了WD抗铜治疗的一般建议外,目前尚无关于WD神经症状管理的指南。本章的目的是根据目前可得的医学文献总结WD神经症状的可能治疗方法。

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