小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 姿势性和/或运动性震颤
- 难以完成精细运动
其他诊断因素
- 使用酒精、苯二氮平类药物、巴比妥类或加巴喷丁等药物后震颤减轻
- 头部或嗓音震颤
- 静止性震颤
危险因素
- 高龄
- 家族史
- 白人血统
- 暴露于环境毒素
诊断性检查
首要检查
- 临床诊断
需考虑的检查
- 头部 CT 或 MRI 扫描
- 血清铜蓝蛋白水平
- 24 小时尿铜
- 甲状腺功能检测
- 震颤生理学检查
- 颅脑单光子发射计算机断层成像(SPECT)扫描
新兴检查
- 震颤稳定性指数
治疗流程
无功能障碍或尴尬
功能障碍或尴尬
撰稿人
作者
Sheng-Han Kuo, MD
Assistant Professor of Neurology
College of Physicians and Surgeons
Columbia University
New York
NY
利益声明
S-HK is an author of a number of references cited in this topic.
Ming-Kai Pan, MD, PhD
Assistant Professor of Neurology
College of Medicine
National Taiwan University
Tapei
Taiwan
利益声明
M-KP has been a member of the Tremor Study Group and the International Parkinson and Movement Disorder Society.
鸣谢
Dr Sheng-Han Kuo and Dr Ming-Kai Pan would like to gratefully acknowledge Dr Zoltan Mari, Dr Martin Kronenbuerger, Dr Adam Burdick, and Dr Kelly D. Foote, previous contributors to this topic.
利益声明
ZM has directed various educational programmes, accredited (CME) by Johns Hopkins University, and has accepted honoraria for consulting. MK, AB, and KDF declare that they have no competing interests.
同行评议者
Roger Weis, MD
Pediatric Neurologist
Kinderneurologisches Zentrum Mainz
Mainz
Germany
利益声明
RW declares that he has no competing interests.
Cory Toth, BSc, MD, FRCP(C)
Assistant Professor of Neurosciences
Hotchkiss Brain Institute
University of Calgary
Alberta
Canada
利益声明
CT declares that he has no competing interests.
鉴别诊断
- 帕金森病
- 肌张力障碍
- Wilson 病(肝豆状核变性)
更多 鉴别诊断指南
- 经颅磁共振引导聚焦超声丘脑毁损术用于治疗药物难治性特发性震颤
- 美国立体定向和功能神经外科学会关于磁共振引导聚焦超声治疗特发性震颤的立场声明
更多 指南患者教育信息
特发性震颤
更多 患者教育信息- 登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明