一名76岁的女性,有2年的帕金森病病史,头部下垂,在服用盐酸多奈哌齐(DNP)3mg/d后迅速发展。用药一个月后,头部下降的程度达到90°。检查发现左侧胸锁乳突肌肥大,但颈部伸肌没有无力.表面肌电图显示在头部屈曲和伸展过程中,胸锁乳突肌和脾资本肌共同收缩。DNP被撤销,导致头部下降的立即改善,两个月后就完成了决议。虽然在帕金森氏病患者中经常看到头滴,以前很少有报告将DNP记录为致病因素。如果帕金森氏症患者出现头部下降,调查DNP用药史很重要.
A 76-year-old woman with a 2-year history of Parkinson\'s disease presented with dropped head, which had developed rapidly after she had been prescribed donepezil hydrochloride (DNP) at 3 mg/day. After one month of medication, the extent of the head drop reached 90°. Examination revealed hypertrophy of the left sternocleidomastoid muscle, but no weakness of the extensor muscles in the cervical region. Surface electromyography demonstrated co-contraction of the sternocleidomastoid and splenius capitus muscles during head flexion and extension. DNP was withdrawn, resulting in immediate amelioration of the head drop, and complete resolution was achieved after two months. Although head drop is often seen in patients with Parkinson\'s disease, few previous
reports have documented DNP as a causative factor. If patients with Parkinson\'s disease develop head drop, it is important to investigate any history of DNP medication.