Konagaya M, Iida M, Konagaya Y
Department of Neurology, Suzuka National Hospital, Mie, Japan.
No To Shinkei. 1994 Apr;46(4):373-8.
In Parkinson disease, the interruption of medication often results in neuroleptic malignant syndrome, which is caused by acute inhibition of the dopaminergic system. It is a serious question in the management of Parkinson disease, whether episode of pyrexia is derived from neuroleptic malignant syndrome or other origins. In this syndrome, muscle damage enhances serum titers of myogenic enzymes and proteins. Myosin light chain-1 (MLC-1), which is a small fragment of myosin, has been reported to show long lasting elevation compared with CK in neuromuscular diseases and cardiac infarction. Then, we evaluated the clinical significance of serum MLC-1 in six patients with neuroleptic malignant syndrome, i.e., four cases of Parkinson disease, one multiple system atrophy and one schizophrenia with acute administration of haloperidol. Muscle breakdown was observed by the elevation of serum MLC-1 titer, which sustained several days after normalization of serum CK titer. In two cases of Parkinson disease, high level of serum MLC-1 was observed in spite of normal body temperature, which suggested pre-clinical stage of neuroleptic malignant syndrome. Thus, we concluded that the estimation of serum MLC-1 is useful in those patients with high risk of neuroleptic malignant syndrome.
在帕金森病中，药物中断常导致神经阻滞剂恶性综合征，这是由多巴胺能系统的急性抑制引起的。在帕金森病的治疗中，发热发作是源于神经阻滞剂恶性综合征还是其他原因，这是一个严重的问题。在这种综合征中，肌肉损伤会提高肌源性酶和蛋白质的血清水平。肌球蛋白轻链-1（MLC-1）是肌球蛋白的一个小片段，据报道，在神经肌肉疾病和心肌梗死中，与肌酸激酶（CK）相比，它的水平会持续长时间升高。然后，我们评估了血清MLC-1在6例神经阻滞剂恶性综合征患者中的临床意义，其中包括4例帕金森病患者、1例多系统萎缩患者和1例因急性服用氟哌啶醇而患精神分裂症的患者。血清MLC-1水平升高表明存在肌肉分解，在血清CK水平恢复正常后，这种情况持续了数天。在2例帕金森病患者中，尽管体温正常，但血清MLC-1水平仍很高，这提示处于神经阻滞剂恶性综合征的临床前期。因此，我们得出结论，血清MLC-1的检测对那些有神经阻滞剂恶性综合征高风险的患者是有用的。
