Clinical Focus ›› 2021, Vol. 36 ›› Issue (4): 379-384.doi: 10.3969/j.issn.1004-583X.2021.04.019
Received:
2020-10-13
Online:
2021-04-20
Published:
2021-05-13
CLC Number:
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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.04.019
项目 | EA1 | EA2 | EA3 | EA4 | EA5 | EA6 | EA7 | EA8 |
---|---|---|---|---|---|---|---|---|
发病年龄(岁) | 2~15 | 2~20 | 1~42 | 23~60 | 3~成年 | 5~14 | <20 | 儿童 |
持续时间 | 数秒至数分钟 | 数小时 | 1 min~6 h | 数小时 | 数小时 | 数小时至数天 | 数小时至数天 | 数小时至24 h |
临床表现 | 肌肉颤搐,偶有构 音障碍、癫痫、耳鸣 | 眼震,偶有癫痫 | 肌肉颤搐、耳鸣, 偶有眼震、癫痫 | 眼震,偶有癫痫、 耳鸣 | 眼震、癫痫 | 癫痫,偶有构 音障碍 | 构音障碍 | 无力 |
CHR基因座 | 12q13 | 19p13 | 1q42 | 不详 | 2q22-q23 | 5p13.2 | 19q13 | 1p36.13 |
基因 | KCNA1 | CACNA1A | 不详 | 不详 | CACNB4 | SLC1A3 | 不详 | UBR4 |
遗传方式 | AD | AD | AD | AD | AD | 散发 | AD | AD |
治疗(乙酰唑胺) | 有效 | 有效 | 有效 | 无效 | 有效 | 有效 | 不详 | 无效 |
项目 | EA1 | EA2 | EA3 | EA4 | EA5 | EA6 | EA7 | EA8 |
---|---|---|---|---|---|---|---|---|
发病年龄(岁) | 2~15 | 2~20 | 1~42 | 23~60 | 3~成年 | 5~14 | <20 | 儿童 |
持续时间 | 数秒至数分钟 | 数小时 | 1 min~6 h | 数小时 | 数小时 | 数小时至数天 | 数小时至数天 | 数小时至24 h |
临床表现 | 肌肉颤搐,偶有构 音障碍、癫痫、耳鸣 | 眼震,偶有癫痫 | 肌肉颤搐、耳鸣, 偶有眼震、癫痫 | 眼震,偶有癫痫、 耳鸣 | 眼震、癫痫 | 癫痫,偶有构 音障碍 | 构音障碍 | 无力 |
CHR基因座 | 12q13 | 19p13 | 1q42 | 不详 | 2q22-q23 | 5p13.2 | 19q13 | 1p36.13 |
基因 | KCNA1 | CACNA1A | 不详 | 不详 | CACNB4 | SLC1A3 | 不详 | UBR4 |
遗传方式 | AD | AD | AD | AD | AD | 散发 | AD | AD |
治疗(乙酰唑胺) | 有效 | 有效 | 有效 | 无效 | 有效 | 有效 | 不详 | 无效 |
疾病 | 基因 | 临床表现 |
---|---|---|
LS | MtDNA及核基因 | 母系或常染色体隐性遗传,多于婴幼儿起病。最常见症状为精神和运动发育延迟、肢体无力以及癫痫发作,部分患者可有眼球活动障碍、共济失调、视力下降和听力丧失 |
AS | POLG | 常染色体隐性遗传,多于出生后数月或2岁内发病。表现为进行性发展的脑病,出现运动和智力发育倒退、难治性癫痫发作和共济失调。 |
MSCAPS | POLG | 常染色体隐性遗传,在儿童和青少年起病。主要表现为共济失调、癫痫发作和智力发育倒退,部分患者伴随肌张力障碍。 |
MERRF | MtDNA 8344 | 母系遗传,多见于儿童,表现为肌阵挛、全面性癫痫发作、肌无力、共济失调、耳聋、智力低下、视力下降等。 |
KSS | MtDNA片段丢失 | 母系遗传,20岁前发病。先后出现持续性眼外肌瘫痪、视网膜色素变性以及心脏传导阻滞,部分患者存在肢体无力、小脑性共济失调、神经性耳聋以及智能减退。 |
NARP | MtDNA 8993 | 母系遗传,儿童到成年发病,出现四肢远端感觉障碍、肢体无力和腱反射消失以及小脑性共济失调症状。 |
疾病 | 基因 | 临床表现 |
---|---|---|
LS | MtDNA及核基因 | 母系或常染色体隐性遗传,多于婴幼儿起病。最常见症状为精神和运动发育延迟、肢体无力以及癫痫发作,部分患者可有眼球活动障碍、共济失调、视力下降和听力丧失 |
AS | POLG | 常染色体隐性遗传,多于出生后数月或2岁内发病。表现为进行性发展的脑病,出现运动和智力发育倒退、难治性癫痫发作和共济失调。 |
MSCAPS | POLG | 常染色体隐性遗传,在儿童和青少年起病。主要表现为共济失调、癫痫发作和智力发育倒退,部分患者伴随肌张力障碍。 |
MERRF | MtDNA 8344 | 母系遗传,多见于儿童,表现为肌阵挛、全面性癫痫发作、肌无力、共济失调、耳聋、智力低下、视力下降等。 |
KSS | MtDNA片段丢失 | 母系遗传,20岁前发病。先后出现持续性眼外肌瘫痪、视网膜色素变性以及心脏传导阻滞,部分患者存在肢体无力、小脑性共济失调、神经性耳聋以及智能减退。 |
NARP | MtDNA 8993 | 母系遗传,儿童到成年发病,出现四肢远端感觉障碍、肢体无力和腱反射消失以及小脑性共济失调症状。 |
[1] |
Akbar U, Ashizawa T. Ataxia[J]. Neurol Clin, 2015,33(1):225-248.
doi: 10.1016/j.ncl.2014.09.004 pmid: 25432731 |
[2] |
Pavone P, Praticò AD, Pavone V, et al. Ataxia in children: early recognition and clinical evaluation[J]. Ital J Pediatr, 2017,43(1):6.
doi: 10.1186/s13052-016-0325-9 pmid: 28257643 |
[3] |
Greco F, Barbagallo ML, Chiodo DC, et al. Severe ataxia as a complication of human parvovirus B19 acute encephalitis in a child[J]. J Child Neurol, 2008,23(9):1078-1080.
doi: 10.1177/0883073808315420 URL |
[4] | 黄光辉, 程小群, 石玲. 以急性小脑共济失调为首发症状的伤寒1例[J]. 疑难病杂志, 2007,6(4):1. |
[5] |
Fritzler MJ, Zhang M, Stinton LM, et al. Spectrum of centrosome autoantibodies in childhood varicella and post-varicella acute cerebellar ataxia[J]. BMC Pediatr, 2003,3:11.
pmid: 14503922 |
[6] |
Uchibori A, Sakuta M, Kusunoki S, et al. Autoantibodies in postinfectious acute cerebellar ataxia[J]. Neurology, 2005,65(7):1114-1116.
pmid: 16217070 |
[7] |
Cimolai N, Mah D, Roland E. Anticentriolar autoantibodies in children with central nervous system manifestations of Mycoplasma pneumoniae infection[J]. J Neurol Neurosurg Psychiatry, 1994,57(5):638-639.
doi: 10.1136/jnnp.57.5.638 URL |
[8] | Horowitz MB, Pang D, Hirsch W. Acute cerebellitis: case report and review[J]. Pediatr Neurosurg, 1991-1992, 7(3):142-145. |
[9] |
Sawaishi Y, Takada G. Acute cerebellitis[J]. Cerebellum, 2002,1(3):223-228.
pmid: 12879984 |
[10] |
Leake JA, Albani S, Kao AS, et al. Acute disseminated encephalomyelitis in childhood: Epidemiologic, clinical and laboratory features[J]. Pediatr Infect Dis J, 2004,23(8):756-764.
pmid: 15295226 |
[11] |
Tenembaum S, Chamoles N, Fejerman N. Acute disseminated encephalomyelitis: A long-term follow-up study of 84 pediatric patients[J]. Neurology, 2002,59(8):1224-1231.
pmid: 12391351 |
[12] | 马林, 于生元, 蔡幼铨, 等. 急性播散性脑脊髓炎的脑部MRI表现[J]. 中华放射学杂志, 2000,34(8):515-517. |
[13] |
Odaka M, Yuki N, Hirata K. Anti-GQ1b IgG antibody syndrome: Clinical and immunological range[J]. J Neurol Neurosurg Psychiatry, 2001,70(1):50-55.
doi: 10.1136/jnnp.70.1.50 URL |
[14] |
Ito M, Kuwabara S, Odaka M, et al. Bickerstaff's brainstem encephalitis and Fisher syndrome form a continuous spectrum: clinical analysis of 581 cases[J]. J Neurol, 2008,255(5):674.
doi: 10.1007/s00415-008-0775-0 pmid: 18274803 |
[15] |
Yuki N, Hartung HP. Guillain-Barre syndrome[J]. N Engl J Med, 2012,366(24):2294-2304.
doi: 10.1056/NEJMra1114525 URL |
[16] | 聂卫平. 197例儿童中毒原因及临床特征分析[J]. 中国实用儿科杂志, 2009,24(6):482-483. |
[17] | 张建军, 贾如, 王立颖, 等. 178例小儿共济失调的病因分析[J]. 黑龙江医学, 2005,29(7):516-516. |
[18] | 于海娜. 药物性共济失调7例临床分析[J]. 中国医药指南, 2017,15(27):177-177. |
[19] | 刘丽娟, 马世尧, 梁敏. 托吡酯的临床应用及不良反应[J]. 现代中西医结合杂志, 2004,13(18):2505-2507. |
[20] |
Mayhew M. Dextromethorphan abuse[J]. J Nurse Pract, 2007,3(9):650-651.
doi: 10.1016/j.nurpra.2007.08.021 URL |
[21] | 汤志鸿, 翟琼香, 王春, 等. 220例儿童脑血管病病因及临床特点分析[J]. 中国现代神经疾病杂志, 2014,14(3):252-256. |
[22] | 柯以铨, 徐如祥, 陈长才, 等. 儿童后颅窝肿瘤的临床特点[J]. 中国实用儿科杂志, 1996,11(4):247-248. |
[23] |
Rudnick E, Khakoo Y, Antunes NL, et al. Opsoclonus-myoclonus-ataxia syndrome in neuroblastoma: Clinical outcome and antineuronal antibodies-a report from the Children's Cancer Group Study[J]. Med Pediatr Oncol, 2001,36(6):612-622.
pmid: 11344492 |
[24] |
Armangué T, Sabater L, Torres-Vega E, et al. Clinical and immunological features of opsoclonus-myoclonus syndrome in the era of neuronal cell surface antibodies[J]. JAMA Neurol, 2016,73(4):417-424.
doi: 10.1001/jamaneurol.2015.4607 pmid: 26856612 |
[25] | Pranzatelli MR, Travelstead AL, Tate ED, et al. B- and T-cell markers in opsoclonus-myoclonus syndrome: Immunophenotyping of CSF lymphocytes[J]. Neurology, 2004,138(2):319-319. |
[26] |
De Grandis E, Parodi S, Conte M, et al. Long-term follow-up of neuroblastoma-associated opsoclonus-myoclonus-ataxia syndrome[J]. Neuropediatrics, 2009,40(3):103-111.
doi: 10.1055/s-0029-1237723 pmid: 20020394 |
[27] |
Gorman MP. Update on diagnosis, treatment, and prognosis in opsoclonus-myoclonus-ataxia syndrome[J]. Curr Opin Pediatr, 2010,22(6):745-750.
doi: 10.1097/MOP.0b013e32833fde3f URL |
[28] |
Wassmer E, Wright E, Rideout S, et al. Idiopathic gait disorder among in-patients with acquired gait disorders admitted to a children’s hospital[J]. Pediatr Rehabil, 2002,5(1):21-28.
pmid: 12396848 |
[29] | 裴竹英, 包新华, 秦炯, 等. 儿童心因性疾病的临床特点[J]. 中华儿科杂志, 2002,40(5):263-265. |
[30] |
Jen JC, Graves TD, Hess EJ, et al. Primary episodic ataxias: Diagnosis, pathogenesis and treatment[J]. Brain, 2007,130(Pt 10):2484-2493.
pmid: 17575281 |
[31] |
Conroy J, Mcgettigan P, Murphy R, et al. A novel locus for episodic ataxia:UBR4 the likely candidate[J]. Eur J Hum Genet, 2014,22(4):505-510.
doi: 10.1038/ejhg.2013.173 URL |
[32] | Soong BW, Morrison PJ. Spinocerebellar ataxias[J]. Handb Clin Neurol, 2018,155:143-174. |
[33] |
Harding AE. Friedreich's ataxia: A clinical and genetic study of 90 families with an analysis of early diagnostic criteria and intrafamilial clustering of clinical features[J]. Brain, 1981,104(3):589-620.
pmid: 7272714 |
[34] |
Koeppen AH. Friedreich's ataxia, pathology, pathogenesis, and molecular genetics[J]. J Neurol Sci, 2011,303(1-2):1-12.
doi: 10.1016/j.jns.2011.01.010 URL |
[35] |
Hart PE, Lodi R, Rajagopalan B, et al. Antioxidant treatment of patients with Friedreich ataxia: Four-year follow-up[J]. Arch Neurol, 2005,62(4):621-626.
doi: 10.1001/archneur.62.4.621 URL |
[36] |
Cooper JM, Korlipara LVP, Hart PE, et al. Coenzyme Q10 and vitamin E deficiency in Friedreich’s ataxia: predictor of efficacy of vitamin E and coenzyme Q10 therapy[J]. Eur J Neurol, 2010,15(12):1371-1379.
doi: 10.1111/ene.2008.15.issue-12 URL |
[37] |
Mariotti C, Solari A, Torta D, et al. Idebenone treatment in Friedreich patients: One-year-long randomized placebo-controlled trial[J]. Neurology, 2003,60(10):1676-1679.
pmid: 12771264 |
[38] |
Miller GW, Ulatowski L, Labut EM, et al. The α-tocopherol transfer protein is essential for vertebrate embryogenesis[J]. PLoS One, 2012,7(10):e47402.
doi: 10.1371/journal.pone.0047402 URL |
[39] |
Gabsi S, Gouider-Khouja N, Belal S, et al. Effect of vitamin E supplementation in patients with ataxia with vitamin E deficiency[J]. Eur J Neurol, 2015,8(5):477-481.
doi: 10.1046/j.1468-1331.2001.00273.x URL |
[40] | Shoulders CC, Brett DJ, Bayllss JD, et al. Abetalipoproteinemia is caused by defects of the gene encoding the 97 kDa subunit of a microsomal triglyceride transfer protein[J]. Humn Mol Genet, 1993,2(12):2109. |
[41] | 陈仕均, 唐海蓉. 微粒体甘油三酯转运蛋白研究进展[J]. 动物医学进展, 2007,28(12):84-89. |
[42] |
Jansen GA, Waterham HR, Wanders RJ. Molecular basis of Refsum disease: Sequence variations in phytanoyl-CoA hydroxylase (PHYH) and the PTS2 receptor (PEX7)[J]. Hum Mutat, 2010,23(3):209-918.
doi: 10.1002/(ISSN)1098-1004 URL |
[43] |
Verhagen MM, Abdo WF, Willemsen MA, et al. Clinical spectrum of ataxia-telangiectasia in adulthood[J]. Neurology, 2009,73(6):430-437.
doi: 10.1212/WNL.0b013e3181af33bd pmid: 19535770 |
[44] |
Mckinnon PJ. ATM and ataxia telangiectasia[J]. EMBO Rep, 2004,5(8):772-776.
doi: 10.1038/sj.embor.7400210 URL |
[45] | Lavin MF. Ataxia-telangiectasia: From a rare disorder to a paradigm for cell signalling and cancer[J]. Nat Rev Mol Cell Biol, 2008,9(10):759-769. |
[46] | 中华医学会神经病学分会, 中华医学会神经病学分会神经肌肉病学组, 中华医学会神经病学分会肌电图与临床神经生理学组. 中国神经系统线粒体病的诊治指南[J]. 中华神经科杂志, 2015,48(12):1045-1051. |
[47] |
Baertling F, Rodenburg RJ, Schaper J, et al. A guide to diagnosis and treatment of Leigh syndrome[J]. J Neurol Neurosurg Psychiatry, 2014,85(3):257-265.
doi: 10.1136/jnnp-2012-304426 URL |
[48] |
Bao X, Wu Y, Wong LJ, et al. Alpers syndrome with prominent white matter changes[J]. Brain Dev, 2008,30(4):295-300.
doi: 10.1016/j.braindev.2007.08.009 URL |
[49] |
Jackson AP. A gene for ataxic cerebral palsy maps to chromosome 9p12-q12[J]. Eur J Hum Genet, 2000,8(4):267-272.
doi: 10.1038/sj.ejhg.5200445 URL |
[50] | 谢明, 周晓鸥, 周虹. 120例脑性瘫痪患儿的脑部CT征象与临床类型的关系[J]. 四川精神卫生, 2003,16(4):244-244. |
[51] | 李君, 贾飞勇, 王贞, 等. 失调型脑性瘫痪患儿临床及智能结构分析[J]. 中国康复理论与实践, 2008,14(2):184-185. |
[1] | LI Xue;WANG Ze-shuai;MA Jian-jun. Research on clinical characteristics and molecular biology of hereditary spinocerebellar ataxia type 3 in Henan province of China [J]. CLINICAL FOCUS, 2010, 25(14): 1197-1200. |
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