摘要
目的:探讨慢性炎性脱髓鞘性多发性神经根神经病(chronic inflammatory demyelinating polyradiculoneuropathy,CIDP)和帕金森综合征的关联。方法:报道2例CIDP合并帕金森综合征患者的临床资料,并复习相关文献进行分析。结果:2例患者的病史特征为:中老年女性,均为慢性起病、逐渐进展并多次复发,临床表现均符合CIDP,在此基础上,两名患者均合并有双上肢震颤及动作迟缓,均符合帕金森综合征的诊断标准。其中例1的震颤早于四肢麻木无力,为姿势性震颤及静止性震颤,局限于双上肢,免疫球蛋白及激素冲击效果好;例2的双手震颤出现晚于双下肢麻木无力,为意向性震颤合并静止性震颤,振幅小,治疗效果欠佳。结论:帕金森综合征可以作为CIDP患者少见的临床表现,针对CIDP进行病因治疗及联合抗帕金森治疗可能改善帕金森综合征症状。
Objective:To explore the relationship between chronic inflammatory demyelinating polyradiculoneuropathy(CIDP)and parkinsonian syndrome.Methods:The clinical data of 2 CIDP patients with parkinsonian syndrome were reported and analyzed,combined with relevant literature review.Results:The medical history of the two patients was characterized by chronic onset,gradual progress and multiple relapses.The clinical manifestations were consistent with CIDP.On this basis,the two patients were complicated with tremor and bradykinesia of both upper limbs.All of them met the diagnostic criteria of partinsonian syndrome.The tremor of case 1 was earlier than that of numbness and weakness of limbs.It was postural and resting tremor,which was limited to both upper limbs.The symptoms of case 1 responded well to immunoglobulin and glucocorticoid.In case 2,the tremor of both hands occurred later than that of numbness and weakness of both lower limbs,which was intentional tremor combined with resting tremor,with small amplitude and poor therapeutic effect.Conclusion:Parkinsonian syndrome can be regarded as a rare clinical manifestation of CIDP.The etiological treatment for CIDP combined with anti-parkinsonian treatment may improve the symptoms of parkinsonian syndrome.
作者
袁永胜
甘彩婷
张慧
沈飞飞
张克忠
YUAN Yong-sheng;GAN Cai-ting;ZHANG Hui;SHEN Fei-fei;ZHANG Ke-zhong(Department of Neurology,The First Affiliated Hospital of Nanjing Medical University Nanjing 210000,China)
出处
《阿尔茨海默病及相关病杂志》
2020年第4期284-287,共4页
Chinese Journal of Alzheimer's Disease and Related Disorders
基金
国家自然科学基金(编号:81901297,81671258)。
关键词
慢性炎性脱髓鞘性多发性神经根神经病
帕金森综合征
Chronic inflammatory demyelinating polyradiculoneuropathy
Parkinsonian syndrome
case report
