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目的:分析帕金森症状为首发表现的多发性硬化(MS)的临床特点及发病机制。方法:选取防城港市第一人民医院收治的2例以帕金森症状为首发表现的多发性硬化患者临床资料,总结其临床特点,探究其发病机制。结果:早期出现无明显诱因的下肢、下颌持续抖动,静坐症状明显,发作时日常活动未受到影响,入睡减轻,后症状逐渐缓解。病情进展时,表情淡漠、动作缓慢僵硬、自觉转弯行走速度缓慢;并逐渐视物模糊、记忆力降低。患者均有复发缓解病史,磁共振成像(MRI)显示双侧侧脑室旁白质及半卵圆中心、双侧多个脑叶白质内T1、T2信号影,则呈稍长斑片状,提示为MS。结论:MS通常也会累及椎体外系的黑质纹状体系等神经系统,掌握帕金森症状为首发表现的多发性硬化的临床特点及其发病机制则是十分必要的。
Objective: To analyze the clinical features and pathogenesis of multiple sclerosis (MS) with Parkinson’s disease as the first manifestation. Methods: Two cases of multiple sclerosis with Parkinson’s disease as the first symptom were selected from the First People’s Hospital of Fangchenggang to summarize the clinical features and explore its pathogenesis. Results: In the early stage, lower extremities with no obvious inducement were found. The mandibular sustained jitter and obvious meditation symptoms were not affected by daily activities. After falling asleep, symptoms gradually eased. When the disease progresses, the expression is indifferent, the action is slow and stiff, and the speed of consciously turning and walking slowly; and gradually blurred vision and memory loss. Patients had a history of recurrence and remission. Magnetic resonance imaging (MRI) showed bilateral lateral ventricular white matter and semi-oval center, and bilateral T1 and T2 signal signs of white matter in bilateral lobes were slightly longer patchy, suggesting that MS. Conclusion: MS usually affects the nervous system of extranodal system such as nigrostriatal system. It is necessary to master the clinical features and pathogenesis of multiple sclerosis with Parkinson’s disease as the first manifestation.