Shulman L M, Singer C, Bean J A, Weiner W J
Department of Neurology, University of Miami School of Medicine, Florida 33136, USA.
Mov Disord. 1996 Jan;11(1):3-7. doi: 10.1002/mds.870110103.
Although sensory symptoms were not originally described in Parkinson's disease (PD), in recent years it has been increasingly recognized that painful sensations and paresthesias occur in approximately 40% of patients. It has been our observation that PD patients often describe a sensation of internal tremor, a feeling of tremor inside the chest, abdomen, arms, or legs that cannot be seen. We investigated the prevalence and characteristics of internal tremor by administering a questionnaire to 100 consecutive patients with PD and 50 age-matched controls seen in our movement disorders center. A sensation of internal tremor was present in 44% of this sample of PD patients and in 6% of the control population (p < 0.0001). The presence of internal tremor was unrelated to Unified Parkinson's Disease Rating Scale score, Hoehn and Yahr stage, duration of disease, or the presence of observable tremor. The frequency of other sensory symptoms (aching, tingling, burning) was higher in the PD patients with internal tremor (73%) than in those without (45%; p = 0.005). Internal tremor is associated with anxiety in 64% of patients (p < 0.0001). It was described as uncomfortable and was unrelieved by antiparkinsonian medication in three quarters of patients. A sensation of internal tremor is commonly reported by PD patients and should be recognized as a useful diagnostic factor in PD.
尽管帕金森病（PD）最初并未被描述有感觉症状，但近年来人们越来越认识到约40%的患者会出现疼痛感觉和感觉异常。我们观察到，帕金森病患者经常描述有一种内在震颤的感觉，即胸部、腹部、手臂或腿部内部的震颤感，肉眼无法看见。我们通过向在我们运动障碍中心就诊的100例连续帕金森病患者和50例年龄匹配的对照者发放问卷，调查了内在震颤的患病率和特征。在这个帕金森病患者样本中，44%存在内在震颤感，而对照人群中这一比例为6%（p<0.0001）。内在震颤的存在与统一帕金森病评定量表评分、Hoehn和Yahr分期、病程或可观察到的震颤的存在无关。有内在震颤的帕金森病患者中其他感觉症状（疼痛、刺痛、灼痛）的发生率（73%）高于无内在震颤的患者（45%；p=0.005）。64%的患者中内在震颤与焦虑相关（p<0.0001）。它被描述为不舒服，四分之三的患者使用抗帕金森药物后症状未缓解。帕金森病患者普遍报告有内在震颤感，并应被视为帕金森病的一个有用诊断因素。
