Sodeyama N, Orimo S, Okiyama R, Arai M, Tamaki M
Department of Neurology, Kanto Teishin Hospital.
Rinsho Shinkeigaku. 1993 Feb;33(2):213-5.
We reported a 25-year-old male with chronic thinner intoxication. He had been sniffing thinner from the age of 15 to 20. Since the age of 20, he developed gait disturbance, weakness of lower extremities, and scanning speech. At the age of 23, three years after he stopped sniffing thinner, he had hyperkinésie volitionnelle (HV) of bilateral upper extremities. MRI study revealed diffuse high intensity areas in the cerebral white matter, thinning of the corpus callosum, and cerebellar and brainstem atrophy on T1 weighted images. On T2 weighted images, low intensity areas in the thalamus, the striatum, the anterior limb of the internal capsule, the tegmentum of midbrain, high intensity areas in middle cerebellar peduncle, the posterior limb of the internal capsule, the lateral part of the cerebral peduncle, and the cerebral white matter were noted. HV almost disappeared with 2.5 mg of clonazepam daily administered. The disappearance of HV by ischemic compression of his arm suggested that input from the periphery might be relevant to the etiology of HV. The time interval between exposure to thinner and the recognition of HV in our case was in agreement with that between the occurrence of cerebrovascular disease and the recognition of HV in the previous reports. We postulated that HV in this case was the manifestation of the denervation hypersensitivity in the dentatorubroolivary system.
我们报告了一名25岁的慢性稀料中毒男性。他从15岁到20岁一直在吸食稀料。自20岁起，他出现步态障碍、下肢无力和吟诗样言语。23岁时，在他停止吸食稀料三年后，双侧上肢出现了随意性运动增多（HV）。MRI研究显示，在T1加权图像上，脑白质有弥漫性高信号区、胼胝体变薄以及小脑和脑干萎缩。在T2加权图像上，丘脑、纹状体、内囊前肢、中脑被盖有低信号区，小脑中脚、内囊后肢、大脑脚外侧部和脑白质有高信号区。每天服用2.5毫克氯硝西泮后，HV几乎消失。通过对其手臂进行缺血性压迫导致HV消失，这表明来自外周的输入可能与HV的病因有关。在我们的病例中，接触稀料到出现HV的时间间隔与先前报告中脑血管疾病发生到出现HV的时间间隔一致。我们推测该病例中的HV是齿状红核橄榄系统失神经超敏反应的表现。
