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脑性瘫痪所致肌张力障碍的深部脑刺激:综述。

Deep brain stimulation for dystonia due to cerebral palsy: A review.

机构信息

Department of Neurology - Movement Disorders, IRCCS Fondazione C. Besta, Milan, Italy.

Department of Neurology - Movement Disorders, IRCCS Fondazione C. Besta, Milan, Italy; Department of Neuro-Rehabilitation, Multimedica, Limbiate, Italy.

出版信息

Eur J Paediatr Neurol. 2018 Mar;22(2):308-315. doi: 10.1016/j.ejpn.2017.12.002. Epub 2017 Dec 14.

Abstract

Cerebral palsy (CP) is a heterogeneous group of syndromes that cause a non-progressive disorder of early onset, with abnormal control of movement and posture. Various aetiologies can cause the CP clinical spectrum, but all have a disruption of motor control in common. CP can be divided into four major types based on the motor disability: predominant spastic, dyskinetic, ataxic and mixed form. Dyskinetic CP (DCP) is the most common cause of acquired dystonia in children. The treatment of DCP is challenging because most individuals have mixed degrees of chorea, athetosis and dystonia. Pharmacological treatment is often unsatisfactory. Functional neurosurgery, in particular deep brain stimulation targeting the basal ganglia or the cerebellum, is emerging as a promising therapeutic approach in selected patients with DCP. We evaluated herein the effects of DBS on patients with DCP in a review of published patient data in the largest available studies.

摘要

脑性瘫痪(CP)是一组异质性综合征,导致早期发病的非进行性运动和姿势障碍。各种病因均可引起 CP 临床谱,但共同点是运动控制障碍。CP 可根据运动障碍分为四大类型:痉挛型、手足徐动型、共济失调型和混合型。手足徐动型 CP(DCP)是儿童获得性肌张力障碍最常见的原因。DCP 的治疗具有挑战性,因为大多数患者存在混合程度的舞蹈症、手足徐动症和肌张力障碍。药物治疗往往效果不佳。功能神经外科,特别是针对基底神经节或小脑的深部脑刺激,在选择的 DCP 患者中作为一种有前途的治疗方法正在出现。我们在此通过对现有最大研究中发表的患者数据进行回顾性评估,评估了 DBS 对 DCP 患者的影响。

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