Sarva Harini, Shanker Vicki Lynn
Division of Movement Disorders Department of Neurology Icahn School of Medicine at Mount Sinai Mount Sinai Beth Israel Medical Center New York New York USA.
Mov Disord Clin Pract. 2014 Jun 12;1(4):291-298. doi: 10.1002/mdc3.12057. eCollection 2014 Dec.
The etiology of cerebellar ataxia (CA) is heterogeneous and includes easily identified and often reversible causes (i.e., drug toxicity and vitamin B12 deficiency) as well as irreversible degenerative conditions. It is the latter that poses a significant therapeutic challenge for practitioners treating this population of patients. To date, there are no U.S. Food and Drug Administration-approved medications for the treatment of CA. The literature, consisting mostly of case reports, case series, and small clinical trials, is sparse and scattered. These studies are difficult to translate clinically because they often describe diverse study populations with various identified and unidentified genetic etiologies. In addition, the reported treatment duration is often brief, and it is uncertain whether any of these options provide substantially lasting benefits. In this article, we review published reports and studies to aid the practitioner counseling patients with degenerative ataxias.
小脑性共济失调(CA)的病因具有异质性,包括易于识别且通常可逆的病因(如药物毒性和维生素B12缺乏)以及不可逆的退行性疾病。正是后者给治疗这类患者的从业者带来了重大的治疗挑战。迄今为止,美国食品药品监督管理局尚未批准用于治疗CA的药物。文献大多由病例报告、病例系列和小型临床试验组成,内容稀少且分散。这些研究难以在临床上进行转化应用,因为它们常常描述的是具有各种已识别和未识别遗传病因的不同研究人群。此外,所报道的治疗持续时间通常较短,而且不确定这些治疗方案中是否有任何一种能带来实质性的持久益处。在本文中,我们回顾已发表的报告和研究,以帮助从业者为患有退行性共济失调的患者提供咨询。