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目的探讨发作性运动诱发性运动障碍(PKD)的临床特点及其诊断治疗。方法对2000年10月至2004年8月上海交通大学附属新华医院门诊的33例PKD患者进行临床分析并随诊。结果PKD患者在发作前均有明显的诱发因素,大多为突然运动、紧张、过度换气或惊吓。临床表现为发作性肌张力障碍、投掷运动、舞蹈样动作或手足徐动等,多为一侧性,持续时间1s至5min,发作频率为每周数次或每天10余次。发作时意识清楚,发作间歇期完全正常。发病年龄4~18岁。8例脑电图异常,其余病例其电生理和神经影像学检查无明确异常。卡马西平类药物治疗有满意的疗效。结论发作性运动诱发性运动障碍病是一种由运动诱发的、短暂的、发作性局部或全身不随意运动,属于离子通路疾病,用抗癫药疗效好。发作性运动障碍的准确分类对确定治疗方案非常重要。
Objective To investigate the clinical features and diagnosis and treatment of episodic motor-induced dyskinesia (PKD). Methods From October 2000 to August 2004, 33 cases of PKD patients from Xinhua Hospital Affiliated to Shanghai Jiaotong University were followed up. Results PKD patients had obvious predisposing factors before the attack, mostly sudden movement, tension, hyperventilation or shock. Clinical manifestations of paroxysmal dystonia, throwing exercise, dance-like movements or hand, foot and Xu act, mostly unilateral, the duration of 1s to 5min, the frequency of seizures several times a week or more than 10 times per day. Awareness when the attack, seizure intermittent period completely normal. Age of onset 4 to 18 years old. 8 cases of abnormal EEG, the remaining cases of electrophysiology and neuroimaging no clear abnormalities. Carbamazepine drug treatment has a satisfactory effect. Conclusions The episode of motor-induced movement disorder is a motor-induced, transient, episodic, or involuntary movement of the body or part of the body. It is an ion-pathogenic disorder and has good efficacy with antiepileptic drugs. Accurate classification of episodic dyskinesis is important for identifying treatment options.