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目的:探讨发作性运动障碍的临床特点、诊断、治疗及误诊原因。方法:回顾性分析发作性运动障碍患者的临床表现、影像学与EEG/video-EEG(视频脑电图)检查及治疗。结果:本组10例,男8例,女2例,起病年龄6~14岁,病程半年~9年;9例由突然的运动诱发,1例为自发发生;临床表现为姿势性肌张力障碍6例,舞蹈样动作2例,投掷样运动1例,手足徐动样动作1例,均为单侧受累;发作时间多为10余秒;6例患者每日有发作,最多1d可发作30余次;CT/MRI均正常,EEG/video-EEG大多正常(9/10);9例卡马西平治疗有效,1例氯硝西泮部分有效。结论:9例为发作性运动障碍中的阵发性运动诱发性运动异常,1例为阵发性非运动诱发性运动异常,前者抗癫药治疗能全部控制发作,后者仅部分有效。
Objective: To investigate the clinical features, diagnosis, treatment and misdiagnosis of episodic dyskinesia. Methods: The clinical manifestations, imaging and EEG / video-EEG (video electroencephalography) examination and treatment of patients with DR were analyzed retrospectively. Results: The group of 10 patients, 8 males and 2 females, age at onset of 6 to 14 years, duration of six months to 9 years; 9 cases induced by sudden exercise, 1 case of spontaneous occurrence; clinical manifestations of postural muscle tone 6 cases of dyskinesia, 2 cases of dance-like movements, 1 case of throwing-like exercises and 1 case of hand-foot-and-arm-like movements, all of which were unilateral involvement; the onset time was more than 10 seconds; 6 cases were attacked daily, up to 1d More than 30 times; CT / MRI were normal, EEG / video-EEG most of the normal (9/10); 9 cases of carbamazepine treatment, 1 cases of clonazepam effective. CONCLUSIONS: Nine patients had paroxysmal paroxysm-induced motor dyskinesia in episodic dyskinesia. One patient had paroxysmal non-motor-induced motor dysfunction. The former was able to fully control the onset of anti-epileptic drugs and the latter was only partially effective.