一名患有6型脊髓小脑共济失调的患者在挥发性麻醉联合硬膜外麻醉后出现难治性头部震颤。
A refractory head tremor appearing after volatile anesthesia combined with epidural anesthesia in a patient with spinocerebellar ataxia type 6.
作者信息
Nishida Takaya, Nakajima Masayori
机构信息
Department of Anesthesiology, Takatsuki General Hospital, 1-3-13, Kosobe-cho, Takatsuki-shi, Osaka-fu, 569-1192, Japan.
出版信息
JA Clin Rep. 2018 Jan 30;4(1):13. doi: 10.1186/s40981-018-0150-9.
Abstract
A 64-year-old female patient with spinocerebellar ataxia type 6 was referred to our department for pancreatic cancer and anesthetized with volatile anesthesia combined with epidural anesthesia for pancreaticoduodenectomy. No complications arose during surgery. On postoperative day 4, a head tremor was noticed at the time of mobilization. The tremor was a postural and "no-no" tremor rather than an intention or resting tremor. The head tremor caused difficulty in eating and in other activities of daily living. No abnormal results were obtained by magnetic resonance imaging of the brain. The tremor was resistant to drugs, including anti-Parkinson drugs and benzodiazepines, and was therefore difficult to treat.
摘要
一名64岁的6型脊髓小脑共济失调女性患者因胰腺癌转诊至我科，并接受挥发性麻醉联合硬膜外麻醉进行胰十二指肠切除术。手术过程中未出现并发症。术后第4天，活动时发现头部震颤。该震颤为姿势性和“点头-摇头”震颤，而非意向性或静止性震颤。头部震颤导致进食及其他日常生活活动困难。脑部磁共振成像未发现异常结果。该震颤对包括抗帕金森药物和苯二氮䓬类药物在内的药物均有抵抗，因此难以治疗。
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