运动障碍病.ppt

抽动症（Tics） 感觉驱动 暂时可被抑制－有鉴别意义 控制后的放松时加重－抽动释放 紧张、劳累时加重，注意力集中或娱乐时减轻 慢性波动性病程 睡眠中可以持续存在 可伴有OCD、ADHD、自残行为 重 点 运动障碍病的概念、分类及常见疾病 帕金森病的病因、发病机制 帕金森病的诊断步骤 帕金森综合症 帕金森病的治疗及并发症处理 首先我们来回顾一下帕金森病的历史。帕金森病在我国已有“悠久历史”，我国古代医学的奠基之作《黄帝内经》中早已对震颤麻痹的症状有所描述。唐代的著名医学家孙思邈在《千金方》中也曾报道了一例震颤麻痹患者。 直到1817年，英国医生James Parkinson报告了6例病例，首次提出“震颤麻痹”并对该疾病进行了描述。 The incidence of parkinson syndrome and Parkinson’s disease rises with age, and has been reported at between five and twenty-four cases per hundred thousand. The best available incidence studies--those from the Rochester, Minnesota, database--suggest the incidence of parkinson syndrome in the U.S.A. is 20.5 per 100,000 population. Because the population is slowly aging, and the recognition of parkinsonism is improving, it is expected that the incidence will slowly rise. Door-to-door prevalence surveys of the general population have revealed that 35-42% of the cases of parkinson syndrome in the general population remain undiagnosed. Most of those would be early cases, those with akinetic-rigid form of parkinsonism, or those who have been mistaken as having had a neurological disease such as essential tremor. The reported prevalence rates range from 57-371 per 100,000 population. In the U.S. and Canada it is estimated that the prevalence is 300 per 100,000 population. This should be regarded as a conservative estimate. A review of 934 patients found the onset of parkinson syndrome was at age 61.6, while the onset of Parkinson’s disease was at age 62.4 years. Parkinsonism is very rare before age 30 and only 4-10% of the cases have onset before the age of 40 years. The cause in idiopathic Parkinson’s disease is unknown, but it is not accelerated aging. Rarely is Parkinson’s disease inherited as a dominant disorder. Mutation of Alpha synuclein gene (chromosome 4q) has been identified in one large Italian family, the Contursi family, and in five Greek families. Mutation of the parkin gene has been identified as the cause of autosomal-recessive juv