脑与神经疾病杂志
腦與神經疾病雜誌
뇌여신경질병잡지
Journal of Brain and Nervous Diseases
2015年
5期
386-389
,共4页
王新平%孙丽梅%韩海玲%严胜利%武一平
王新平%孫麗梅%韓海玲%嚴勝利%武一平
왕신평%손려매%한해령%엄성리%무일평
短暂性脑缺血发作%肢体抖动%视频脑电图监测%低灌注%卒中
短暫性腦缺血髮作%肢體抖動%視頻腦電圖鑑測%低灌註%卒中
단잠성뇌결혈발작%지체두동%시빈뇌전도감측%저관주%졸중
Transient ischemic attacks%Limb shaking%Video-VEEG%Low perfusion%Stroke
目的探讨肢体抖动短暂性脑缺血发作的临床特点。方法分析本院神经内科2例肢体抖动短暂性脑缺血发作( LS-TIA)患者的临床资料。结果2例患者均在60岁以后发病,临床表现为活动后肢体抖动、无力,休息后缓解。例1头颅MRA显示颅内动脉粥样硬化样改变,抖动肢体对侧血管大脑中动脉M2段轻度狭窄,同侧颈内动脉颅内段中度狭窄,前交通动脉中度狭窄;例2头颈CTA显示抖动肢体对侧颈内动脉起始部狭窄约70%~80%,大脑中动脉M1段起始部闭塞。例1患者视频脑电图( VEEG)监测到3次肢体抖动发作,未发现异常癫痫波。2例患者在常规治疗下均给予扩容治疗以提高大脑血流灌注,发作次数均减少,1个月后其中1例进展为脑卒中。结论 LS-TIA是TIA的一种罕见的发作形式,应注意与局灶性运动性癫痫发作相区别,尽早诊断及提高大脑血流灌注可以减少发作或减低卒中发生的风险。
目的探討肢體抖動短暫性腦缺血髮作的臨床特點。方法分析本院神經內科2例肢體抖動短暫性腦缺血髮作( LS-TIA)患者的臨床資料。結果2例患者均在60歲以後髮病,臨床錶現為活動後肢體抖動、無力,休息後緩解。例1頭顱MRA顯示顱內動脈粥樣硬化樣改變,抖動肢體對側血管大腦中動脈M2段輕度狹窄,同側頸內動脈顱內段中度狹窄,前交通動脈中度狹窄;例2頭頸CTA顯示抖動肢體對側頸內動脈起始部狹窄約70%~80%,大腦中動脈M1段起始部閉塞。例1患者視頻腦電圖( VEEG)鑑測到3次肢體抖動髮作,未髮現異常癲癇波。2例患者在常規治療下均給予擴容治療以提高大腦血流灌註,髮作次數均減少,1箇月後其中1例進展為腦卒中。結論 LS-TIA是TIA的一種罕見的髮作形式,應註意與跼竈性運動性癲癇髮作相區彆,儘早診斷及提高大腦血流灌註可以減少髮作或減低卒中髮生的風險。
목적탐토지체두동단잠성뇌결혈발작적림상특점。방법분석본원신경내과2례지체두동단잠성뇌결혈발작( LS-TIA)환자적림상자료。결과2례환자균재60세이후발병,림상표현위활동후지체두동、무력,휴식후완해。례1두로MRA현시로내동맥죽양경화양개변,두동지체대측혈관대뇌중동맥M2단경도협착,동측경내동맥로내단중도협착,전교통동맥중도협착;례2두경CTA현시두동지체대측경내동맥기시부협착약70%~80%,대뇌중동맥M1단기시부폐새。례1환자시빈뇌전도( VEEG)감측도3차지체두동발작,미발현이상전간파。2례환자재상규치료하균급여확용치료이제고대뇌혈류관주,발작차수균감소,1개월후기중1례진전위뇌졸중。결론 LS-TIA시TIA적일충한견적발작형식,응주의여국조성운동성전간발작상구별,진조진단급제고대뇌혈류관주가이감소발작혹감저졸중발생적풍험。
Objective To study the clinical manifestations and possible pathogenesis in two patients with limb shaking transient ischemic attacks ( LS-TIA ) .Methods We enrolled 2 patients with LS-TIA in neurology department .Results Two patients were in 60 years old later onset of the disease , with several years history of diabetes and high blood pressure , adhere to the antihypertensive therapy .The clinical manifestations was dithering after activities, weakness, they could alleviate after rest .1 cases of brain MRA display intracranial atherosclerosis , left internal carotid artery intracranial section moderate stenosis , left before the traffic a moderate stenosis , on the right side of the brain artery M 2 period of mild stenosis .1 cases of CTA showed:the right internal carotid artery initial department narrow about 70%-80%, on the right side of the brain artery M 1 period of initial department block .1 patients VEEG inspection did not see epilepsy wave , The management of improving cerebral blood flow , one case development as the stroke , an another reduced the attack .Conclusion Limb shaking is a rather uncommon form of TIA that should be recognized and differentiated from conditions like focal motor seizure .Moreover, a quick diagnosis is important both to abolish the attacks and reduce the risk of major stroke .