摘要
原发性震颤(ET)也称特发性震颤,主要临床表现为双上肢4~12 Hz动作性震颤,可伴或不伴头部、口面部、声音或下肢震颤。该病发病机制尚未完全明确,皮质-脑桥-小脑-丘脑-皮质环路的节律性震荡是ET的主要病理生理学机制。目前ET的治疗方法主要包括药物治疗(口服药物和注射A型肉毒毒素)、手术治疗、康复治疗等,约1/3的ET患者对药物治疗反应不佳。目前,脑深部电刺激术(DBS)已成为药物难治性ET的首选治疗方法,我国已有多个中心开展DBS治疗药物难治性ET患者,但国内外尚无专门针对性的指南或共识。为进一步规范我国DBS治疗ET的适应证和流程,进一步加强神经内、外科之间的密切配合,提高诊疗水平,相关领域的专家经过充分讨论,制订了本共识。
Essential tremor(ET),also known as idiopathic tremor,is mainly characterized by 4-12 Hz motor tremor of both upper limbs,with or without tremor of head,orofacial,voice or lower limbs.The pathogenesis of the disease is not completely clear.The rhythmic oscillation of cortical pontine cerebellar thalamus cortical circuit is the main pathophysiological mechanism of ET.At present,the treatment methods of ET mainly include drug treatment(oral drug and injection of botulinum toxin A),surgical treatment and rehabilitation treatment.About 1/3 of ET patients have poor response to drug treatment.Nowadays,deep brain stimulation(DBS)has become the first choice for the treatment of drug-resistant ET.Many centers in China have carried out DBS in the treatment of drug-resistant ET patients,but there is no specific guide or consensus at home and abroad.In order to further standardize the indications and process of DBS in the treatment of ET in China,further strengthen the close cooperation between neurology and neurosurgery,and improve the level of diagnosis and treatment,experts in relevant fields have formulated this consensus after full discussion.
作者
中华医学会神经病学分会帕金森病及运动障碍学组
中国医师协会神经内科医师分会帕金森病及运动障碍学组
中华医学会神经外科学分会神经生理学组
中国神经科学学会神经退行性疾病分会
陈生弟
陈海波
张建国
孙伯民
王丽娟
Chinese Society of Parkinson′s Disease and Movement Disorders;Parkinson′s Disease and Movement Disorder Section of Neurologist Branch of Chinese Medical Doctor Association;Neurophysiology Group of Neurosurgery Branch of Chinese Medical Association;Neurodegenerative Disease Branch of Chinese Neuroscience Society;Chen Shengdi;Chen Haibo;Zhang Jianguo;Sun Bomin;Wang Lijuan(不详;Department of Neurology,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Neurology,Beijing Hospital,National Geriatric Center,Beijing 100730,China;Department of Neurosurgery,Beijing Tiantan Hospital Affiliated to Capital Medical University,Beijing 100070,China;Department of Functional Neurosurgery,Ruijin Hospital Affiliated to Medical College of Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Neurology,Guangdong Provincial Peopled Hospital,Guangzhou 510080,China)
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2021年第12期1225-1233,共9页
Chinese Journal of Neurology
