帕金森症候群
帕金森症候群(Parkinsonism)是和运动机能相关的临床症候群,其特征是颤抖、运动功能减退、僵硬及平衡障碍[1][2]。在帕金森氏症(PD)患者身上会有类似症状(此症候群因此而得名),而路易氏体失智症(DLB)、帕金森病性失智症(PDD)等疾病也会有此症状。这类症候群的病因范围很广,包括神经退化障碍疾病、药物、毒素、代谢疾病,或是帕金森氏症以外的神经性疾病[3]。
帕金森症候群 Parkinsonism | |
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病因 | |
分类和外部资源 | |
医学专科 | 神经学 |
ICD-11 | 8A00 |
ICD-10 | G21、G22 |
DiseasesDB | 24212 |
MedlinePlus | 000759 |
Orphanet | 68402 |
病因
编辑药物引起
编辑有帕金森症候群的人当中,约有7%是因为药物的副作用而造成的,主要是因为抗精神病药,特别是吩噻嗪(例如perphenazine及氯丙嗪)、噻吨(例如三氟噻吨及珠氯噻醇)及丁酰苯(例如氟哌啶醇),偶尔也有因为抗忧郁药物而造成。药物引起帕金森症候群的盛行率会随年龄而上升。药物引起的帕金森症候群一但出现,多半会维持原有的程度,不像帕金森氏症会渐渐恶化[4]。
毒素
编辑有发现杀虫剂或除草剂暴露程度和帕金森氏症之间的关联性。若暴露在百草枯或锰乃浦/锌锰乃浦下,风险是原来的两倍[5]。
已证实慢性锰(Mn)暴露会造成类似帕金森症候群的疾病,其特征是运动障碍,此症状无法用典型的帕金森症治疗方式来治疗,因此推测除了典型黑质内多巴胺能损失外,包括有其他的致病途径[6]。锰会在基底核内累积,因此造成运动障碍[7]有一种和SLC30A10基因(锰外流转运蛋白,减少细胞内锰所必需的蛋白)有关的变异和这种类似帕金森症候群疾病有关[8]。在这疾病中看不到帕金森氏症中典型的路易体[7]。
诊断
编辑许多疾病会造成帕金森症候群。
- 皮质基底核退化症[9]
- 路易氏体失智症[9]
- 额颞失智症(匹克氏病)[10]
- 格斯特曼–斯特劳斯勒–申克综合征[9]
- 亨丁顿舞蹈症[9]
- Lytico-bodig症(ALS complex of Guam)[9]
- 多系统萎缩(Shy–Drager症候群)[9]
- 神经吞噬作用[9]
- 神经元蜡样脂褐质储积症[9]
- 少脑桥小脑萎缩[9]
- 泛酸盐激活酵素关联之神经退化性疾病,也称为具有脑部铁质积聚的神经变性(neurodegeneration with brain iron accumulation)[9]
- 帕金突变(遗传性青少年肌张力障碍)[9]
- 帕金森氏症[9]
- 帕金森氏症性失智症[11]
- 进行性上眼神经核麻痹症[9]
- 肝豆状核变性[9]
- X连锁性肌张力障碍帕金森症(Lubag症候群)[9]
- 药物引发(伪帕金森症候群)
- 感染
- 毒素
- 番荔枝科[16]
- 一氧化碳[9]
- 二硫化碳[9]
- 氰化物[9]
- 乙醇[9]
- 己烷[17]
- 锰乃浦/锌锰乃浦[5]
- 锰[9][6]
- 汞[9]
- 甲醇[9]
- MPTP[9][18]
- 百草枯[19][5]
- 鱼藤酮[19]
- 甲苯[20](吸入滥用)[21]
- 创伤
- 血管的
- Binswanger病(皮质下白质脑病)[9]
- 血管性痴呆(多发梗塞性)[9]
- 其他
- 脑干受损(特别是黑质的多巴胺能核)[22][23]或是基底核(特别是苍白球)[24]或丘脑的受损[25]
- 甲状腺机能低下症[9]
- 站立性颤抖症[26]
- 肿瘤伴随症候群:因为癌症产生的抗体引发的神经性症状[27]
- 快速发作的肌张力障碍性帕金森病[28]
- 常染色体隐性遗传性少年帕金森病[29]
原发性震颤
编辑参考资料
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