最近审阅: 29 十月 2020
最近更新: 30 一月 2019

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 主动肌和拮抗肌的同时收缩
  • 肌肉疼痛
  • 运动可诱发或加重是肌张力障碍普遍特征
  • 眼睑痉挛
  • 斜颈
  • 手痉挛
  • 足痉挛
  • 急性发病(服用抗多巴胺类药物后的 5 天内)
  • 之前存在的全身性肌张力障碍急剧恶化

其他诊断因素

  • 受累身体部位的扭转
  • 行为拮抗(感觉假象)
  • 扩散到其他身体部位
  • 帕金森氏病
  • 肌阵挛
  • 震颤、无力或痉挛
  • 反射性交感神经营养障碍
  • 裂隙灯检查中的 Kayser-Fleischer 环

危险因素

  • 肌张力障碍家族史
  • 受累部位的重复性运动
  • 出生创伤和儿童发育迟缓
  • 服用抗多巴胺类药物
  • 创伤
  • 基因突变
  • 德系犹太人族群
  • 基底神经节的结构性损伤
  • 帕金森综合征

诊断性检查

首要检查

  • 左旋多巴反应性
更多 首要检查

需考虑的检查

  • 头颅磁共振成像
  • 血清铜蓝蛋白水平
  • 24 小时尿铜
  • DYT1 基因检测
  • GCH1 基因检测
更多 需考虑的检查

治疗流程

撰稿人

Associate Professor of Neurology

Parkinson's Disease and Movement Disorders Center

Beth Israel Deaconess Medical Center

Boston

MA

利益声明

SF is employed by the Beth Israel Deaconess Medical Center, which has received funding from Allergan to support partial fellowship training.

Dr Samuel Frank would like to gratefully acknowledge Dr Ludy C. Shih, Dr David K. Simon, and Dr Daniel Tarsy, previous contributors to this topic.

利益声明

LCS is now an employee of Biogen, Inc. and has received funding from the NIH Dystonia Coalition project for participant enrolment. DKS has received consulting fees from the Gerson Lehrman Group. DKS is an author of a reference cited in this topic. DT has received an unrestricted grant from Allergan and Medtronic being used for education. He received unrestricted funds for patient education from Allergan, Boehringer Ingelheim, Valeant, and Teva Neurosciences. He has received research funds from Solvay and Neurogen. DT is an author of a number of references cited in this topic.

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Reader in Clinical Neurology

Honorary Consultant

Institute of Neurology

National Hospital for Neurology and Neurosurgery

London

UK

利益声明

PDL declares that she has no competing interests.

Assistant Professor

Director

Movement Disorder Center

Dept of Neurology

University of Florida

Tampa

FL

利益声明

ZH has been a consultant for Allergan and a speaker for Novartis and TEVA.

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