运动障碍分类与诊断.pptVIP

美国运动障碍学会和世界震颤研究组织的ET诊断标准 核心标准 1.双手及前臂的动作性震颤； 2.无齿轮现象，不伴有其他神经系统体征； 3. 或仅有头部震颤，但不伴有肌张力障碍。 次要标准 1. 病程超过3年； 2. 有阳性家族史； 3. 饮酒后震颤减轻。  排除标准 １、伴有其他神经系统体征，或在震颤发生前不 久有外伤史； ２、由药物、焦虑、抑郁、甲亢等引起的生理亢 进性震颤； ３、有心因性震颤的病史； ４、突然起病或分段进展； ５、原发性直立性震颤； ６、仅有位置特异性或目标特异性震颤，包括职业 性震颤和原发性书写震颤； ７、仅有言语、舌、颏或腿部震颤。 美国运动障碍学会和世界震颤研究组织的ET诊断标准 NIH Collaborative Genetic Criteria Tremor Severity Scale 0 = none 1 = minimal (barely noticeable) 2 = obvious, noticeable but probably not disabling (2 cm excursions) 3 = moderate, probably partially disabling  (2 cm to 4 cm excursions) 4 = severe, coarse, and disabling  ( 4 cm excursions) NIH Collaborative Genetic Criteria: Definite ET 2+ amplitude rating for bilateral arm tremor, Or 2+ amplitude rating in one arm and 1+ amplitude rating in other arm, Or 1+ amplitude rating in at least one arm and predominant cranial/cervical tremor with 2+ amplitude rating NIH Collaborative Genetic Criteria: Probable ET 1+ bilateral arm tremor Or Isolated 2+ cranial/cervical tremor Or Convincing history of ET Exclude: obvious secondary causes (e.g., physiologic, drug-induced, CMT, etc.) NIH Collaborative Genetic Criteria: Possible ET Isolated 1+ cranial/cervical tremor Or Task- or position-specific arm tremor Or Unilateral arm tremor Or Orthostatic tremor NIH Collaborative Genetic Criteria: Unrateable ET Tremor is coexistent with: Other neurologic disease Therapy with anti-tremor or tremorogenic drugs Untreated thyroid disease Coffee withdrawal or abstention, etc. Classic ET: Inclusion Criteria Bilateral, largely postural or kinetic tremor involving the hands and forearms Tremor is persistent and visible Or Additional or isolated tremor of the head in the absence of abnormal posturing Deuschl G, Bain P, Brin M, and an Ad Hoc Scientific Committee. Consensus statement of the Movement Disorder Society on tremor. Mov Disord 1998;13 (suppl 3):2-23. Classic ET: Exclusion Criteria 1. Other abnormal neurologic signs (es