格雷夫斯病中的假性直立性震颤：帕金森病的早期可能信号？
Pseudo-Orthostatic Tremor in Graves' Disease: A Possible Early Sign of Parkinsonism?
机构信息
Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
IRCCS Mondino Foundation, Pavia, Italy.
出版信息
Tremor Other Hyperkinet Mov (N Y). 2024 Jul 24;14:39. doi: 10.5334/tohm.924. eCollection 2024.
BACKGROUND
Pseudo-orthostatic tremor is a hyperkinetic movement disorder usually associated with other neurological comorbidities, mainly Parkinson's disease.
CASE REPORT
A 65-year-old male presented with unsteadiness and leg tremor while standing. Electrophysiological evaluation confirmed the presence of pseudo-orthostatic tremor. Blood test showed an undiagnosed Graves' disease. A complete remission of tremor was achieved with methimazole. Dopamine transporter scintigraphy showed a mild reduction of the striatal binding, bilaterally.
DISCUSSION
Graves' disease can be associated with pseudo-orthostatic tremor. Thyroid function should be assessed in patients complaining of unsteadiness. The causative role of hyperthyroidism in determining dopaminergic degeneration and uncovering subclinical parkinsonism warrants further investigations.
背景
假性直立性震颤是一种运动障碍，通常与其他神经共病有关，主要是帕金森病。
病例报告
一名 65 岁男性在站立时出现站立不稳和腿部震颤。电生理评估证实存在假性直立性震颤。血液检查显示未确诊的格雷夫斯病。甲巯咪唑治疗后震颤完全缓解。多巴胺转运体闪烁显像显示双侧纹状体结合轻度减少。
讨论
格雷夫斯病可伴发假性直立性震颤。出现站立不稳的患者应评估甲状腺功能。甲状腺功能亢进症在决定多巴胺能变性和揭示亚临床帕金森病中的致病作用值得进一步研究。
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