Klawans H L, Moses H, Nausieda P A, Bergen D, Weiner W J
N Engl J Med. 1976 Dec 9;295(24):1348-50. doi: 10.1056/NEJM197612092952404.
Acute hemiballismus due to a cerebrovascular lesion may have a grave prognosis. In the past nine years, we have treated 11 patients who had an acute onset of hemiballismus believed to be the result of an acute vascular lesion with neuroleptic drugs (most frequently haloperidol). None of the 11 died, and the movement disorders were greatly reduced or eliminated. In eight patients the drugs were withdrawn within six months, without recurrence of the movement disorders. Spinal-fluid homovanillic acid levels were increased in three patients, suggesting that altered dopaminergic feedback mechanisms may be involved in the pathophysiology of hemiballismus. Our observations suggest that the prognosis of hemiballismus is not necessarily as grave as has been believed, and that neuroleptic therapy may alter the outcome of this disorder.
脑血管病变所致的急性偏身投掷症预后可能不佳。在过去九年中，我们治疗了11例急性起病的偏身投掷症患者，这些患者被认为是急性血管病变所致，我们使用了抗精神病药物（最常用氟哌啶醇）进行治疗。11例患者均未死亡，运动障碍大为减轻或消除。8例患者在6个月内停用药物，运动障碍未复发。3例患者脑脊液高香草酸水平升高，提示多巴胺能反馈机制改变可能参与偏身投掷症的病理生理过程。我们的观察结果表明，偏身投掷症的预后未必像人们认为的那样严重，抗精神病药物治疗可能改变这种疾病的结局。
