肢体抖动短暂性脑缺血发作临床分析.docVIP

肢体抖动短暂性脑缺血发作临床分析【摘要】 目的 探讨肢体抖动短暂性脑缺血发作((lmib-shaking transient ischemic ttack,LS-TIA)的临床特点,提高临床医生对本病的认识。方法 回顾性分析了我院2004~2009年间诊治的6例LS-TIA患者的临床资料。结果 6例患者均表现为肢体发作性短暂不能控制的抖动,4例发作有明显诱因,其中2例曾被误诊为癫痫,给予抗癫痫治疗无效。全部患者均有抖动肢体对侧至少1条以上颅内和(或)颅外动脉严重狭窄或闭塞,头部核磁共振2例显示抖动肢体对侧分水岭脑梗死,发作期脑电图检查未见癫痫波释放,给予抗血小板聚集、扩容、血管重建术治疗后,症状均消失。结论 发作性肢体抖动要考虑到LS-TIA的可能,其通常提示大血管严重狭窄或闭塞,抗栓或血管重建术可能是有效的治疗方法。 【关键词】 短暂性脑缺血发作;肢体抖动;血管狭窄 Clinical analysis of limb-shaking transient ischemic attack LIU Chun-hong,SONG Yan-feng,Liu Gui-lian.Department of Neurology,the Second People’s Hospital of Liao cheng Affiliated to Tai Shan Medical College,Linqing,Shandong 252601,China 【Abstract】 Objective To study the clinical manifestations in six patients with limb-shaking transient ischemic attack (LS-TIA) in order to improve the recognition of this disorder.Methods We retrospectively analyzed the clinical data of 6 patients with LS-TIA who received treatment in our hospital from 2004 to 2009.Results The clinical features included a paroxysmal,brief,involuntary limb-shaking.Four patients had obvious precipitating factors.2 patients were misdiagnosed as epilepsy.And antiepileptic had no effect.The contralateral internal cervical artery or middle cerebral artery showed critical stenosis or occlusion.In all six patients,the brain MRI showed typical watershed cerebral infarction in 2patients,video-EEG studies failed to show epileptiform activity.The antiplatelet drugs,volum dilution therapy or percutaneous angioplasty were administered in six patients.All of them became asymptomatic.Conclusion LS-TIA is one form of transient ischemic attacks.The patients with LS-TIA almosthave severe carotid occlusive disease,and the antiplatelet drugs or percutaneous angioplasty was effective for limb-shaking. 【Key words】Transient ischemic attacks;Limb shaking;Carotid occlusive 肢体抖动短暂性脑缺血发作(lmib-shaking transient ischemic attack,LS-TIA)临床较少见,属于短暂性脑缺血发作的一种,常被忽视或误诊为局灶性运动性癫痫发作而延误治疗,应引起临床医生的注意。本文总结我院2004~2009年间诊治的6例LS-TIA病例,旨在警示临床医师提高