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[利血平抑制的眼阵挛-肌阵挛综合征]

[Opsoclonus-polymyoclonia syndrome suppressed with reserpine].

作者信息

Harada Y, Ishimitsu H, Nishimoto K, Miyata I, Matsumi N

出版信息

No To Shinkei. 1986 Apr;38(4):359-62.

PMID:3718780
Abstract

A 38-year-old man was admitted to Iwakuni National Hospital on July 6, 1978, with the complaints of difficulty seeing and walking. Two weeks before admission, he first experienced dizziness and it slowly progressed to uncontrollable tremor-like movements of the whole body. On admission, he was alert, oriented and afebrile. He had not experienced nausea, vomiting nor headache. He showed irregular horizontal oscillations of the eyes. Electronystagmographic study showed that this jerky eye movement appeared especially with changes of fixation of the eyes. It was also recorded during conjugate eye movement, and while he closed his eyes. He was ataxic, unable to walk, but no other abnormalities in cerebellar functions were observed. Spinal tap was performed and yielded watery clear cerebrospinal fluid containing 9/mm3 mononuclear cells. Clonazepam was given, 1.5 mg per day, for three days followed by doses of 3 mg per day. Improvement in walking was observed one week after starting the medication, when reserpine was started at a dose of 1 mg per day and increased to a dose of 1.5 mg per day in three days. One week after starting reserpine, opsoclonus improved markedly and he became able to read again. He was discharged home on September 3, 1978. Six months after admission, reserpine was decreased to 0.5 mg per day. Difficulty in reading developed within a month. Reserpine was given 1.0 mg per day and the doses was continuously given for next three months. One year after admission, he is back to his former occupation without medication. He complains of slight difficulty in reading for more than an hour, and in watching TV.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

一名38岁男性于1978年7月6日因视物及行走困难入住岩国市立医院。入院前两周,他首次出现头晕,并逐渐发展为全身无法控制的震颤样运动。入院时,他意识清醒,定向力正常,无发热。他未曾经历过恶心、呕吐或头痛。他的眼睛出现不规则的水平摆动。眼震电图研究表明,这种急促的眼球运动尤其在眼球注视改变时出现。在共轭眼球运动及闭眼时也有记录。他共济失调,无法行走,但未观察到小脑功能的其他异常。进行了腰椎穿刺,脑脊液清澈如水,每立方毫米含9个单核细胞。给予氯硝西泮,每日1.5毫克,持续三天,之后每日剂量为3毫克。开始用药一周后,观察到行走能力有所改善,此时开始使用利血平,每日剂量1毫克,三天后增至每日1.5毫克。开始使用利血平一周后,视阵挛明显改善,他又能够阅读了。他于1978年9月3日出院回家。入院六个月后,利血平剂量减至每日0.5毫克。一个月内出现阅读困难。给予利血平每日1.0毫克,并持续用药三个月。入院一年后,他无需用药即可恢复原工作。他抱怨阅读超过一小时及看电视时会有轻微困难。(摘要截选至250字)

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