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·头颈疾病·

肌萎缩性双侧臂瘫临床特征及病因分析*

作者:罗 翰 黄巧英 褚晓凡

所属单位:暨南大学第二临床医学院神经内科 (广东 深圳 518020)

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摘要

目的 分析肌萎缩性双侧臂瘫的临床特征及病因,提高对该病的认识。方法 通过询问病史、体格检查、神经电生理 学检查,并结合文献复习,对该病的临床特征和病因进行分析。结果 肌萎缩性双侧臂瘫患者表现为双上肢近端显 著无力和双侧上肢带肌明显萎缩,而双下肢功能较少受损。该病进展较经典的肌萎缩侧索硬化相对缓慢、女性罕 见,发病原因可能与基因突变相关。结论 肌萎缩性双侧臂瘫的临床特征和病因学分析对其筛查和早期诊断具有重 要价值。

Objective To analyze the clinical features and etiology of brachial amyotrophic diplegia and raise the awareness of this disease. Methods Analyze the clinical features and etiology of the disease by carefully asking the history, making physical examination and clinical electric neurophysiology examination and combining with the literature review. Results The patients with brachial amyotrophic diplegia have the features that the ends of their both upper limbs are significantly weak and the muscles of their bilateral upper limbs are significantly atrophied, with little or no functional impairment of the legs. However, compared with classical upper limb onset amyotrophic lateral sclerosis, this disease makes slower progress and is rarely found on women. The etiology may be related to gene mutation. Conclusion The analysis of the clinical features and etiology of brachial amyotrophic diplegia has a significant value in its screening and early clinical diagnosis.

【关键词】肌萎缩双侧臂瘫;桶人综合征;肌肉萎缩;神经电生理学;基因

【中图分类号】R338.8

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2015.06.001

前言

肌萎缩性双侧臂瘫(brachial amyotrophic diplegia,BAD)以上肢局限受累起病,表现为双上肢 近端对称的无力和肌肉萎缩、腱反射减退等,后期可 出现吞咽困难和呼吸困难[1]。因患者表现为双上肢瘫 痪,而双下肢运动功能正常,如同上身局限于桶内, 故被认为是神经源性桶人综合征的一种类型。该病国 内的病例报道中多以男性患者为主,女性患者甚为少 见。笔者诊断1例女性患者,现结合文献复习,分析 其临床特征及病因,旨在加强对该病的认识,减少对 该病的误诊。