披着羊皮的狼：皮质基底节综合征中的“异肢”
A Wolf in Sheep's Clothing: An "Alien Leg" in Corticobasal Syndrome.
作者信息
Olszewska Diana Angelika, McCarthy Allan, Murray Brian, Magennis Brian, Connolly Sean, Lynch Tim
机构信息
Department of Neurology, Dublin Neurological Institute, Mater Misericordiae University Hospital, Dublin, Ireland.
Department of Clinical Neurophysiology, St Vincent's University Hospital, Dublin, Ireland.
出版信息
Tremor Other Hyperkinet Mov (N Y). 2017 Apr 26;7:455. doi: 10.7916/D86D5ZT8. eCollection 2017.
BACKGROUND
Alien limb phenomenon occurs in 50-60% of patients with corticobasal syndrome (CBS) and usually presents with an "alien hand" phenomenon. The "alien foot" presentation is rarer and may be misdiagnosed, as foot involvement can lead to erroneous localization of the clinical problem to the knee, hip, or back. Subsequently misdiagnoses such as myelopathy, radiculopathy, functional disorder, stiff leg syndrome, neuromyotonia, and painful leg moving toes syndrome may occur.
CASE REPORT
We describe two patients with alien foot symptoms that resulted in multiple opinions from different specialists, multiple diagnostic and therapeutic procedures, and delayed diagnosis. Eventually a diagnosis of CBS was made in both. Alien foot symptoms may be more common than initially thought and can result in a delayed diagnosis of CBS.
CONCLUSION
The inclusion of this clinical finding in recently proposed diagnostic criteria highlights the need for increased clinical awareness.
背景
异己肢体现象见于50%至60%的皮质基底节综合征（CBS）患者，通常表现为“异己手”现象。“异己足”表现较为罕见，可能会被误诊，因为足部受累可导致临床问题错误定位于膝、髋或背部。随后可能会出现诸如脊髓病、神经根病、功能障碍、僵腿综合征、神经肌强直和疼痛性腿部动趾综合征等误诊。
病例报告
我们描述了两名有异己足症状的患者，这些症状导致了不同专科医生的多种意见、多项诊断和治疗程序以及诊断延迟。最终两人均被诊断为CBS。异己足症状可能比最初认为的更为常见，并可导致CBS的诊断延迟。
结论
最近提出的诊断标准纳入了这一临床发现，凸显了提高临床意识的必要性。
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