■自发性低颅压(SIH),由脑脊液脊髓漏引起的可治疗疾病,通常表现为体位性头痛,恶心,呕吐,头晕,还有耳鸣.一部分病人,尤其是那些大脑结构下垂的人(“大脑下垂综合征”),发展几个运动异常。由于SIH可以用硬膜外血贴片(EBP)治疗,运动障碍神经学家应该熟悉这种综合征。
作者于2024年7月在PubMed进行了文献检索,使用布尔短语-((\“大脑下垂\”)或(\“颅内低血压\”)和(((((((((\“运动障碍\”))或(\“非自愿运动\”))\“\”)\”(\“Tremor\”)\“Chysmia(
■我们列出了21例强调存在运动障碍的病例报告/系列。报道最多的现象学是步态不稳定。虽然它通常出现在典型SIH症状的背景下,很少,患者可能存在孤立的步态功能障碍。震颤是第二多报道的现象学,姿势性和运动性震颤是常见的亚型。在SIH中也有福尔摩斯震颤的报道。其他报道的现象学是帕金森主义,舞蹈病,和肌张力障碍.一项研究报告了一种独特的现象学,即35.3%的患者强迫性重复屈曲和屏气。在大多数患者中,EBP导致临床和放射学上的实质性改善。
■由SIH引起的脑下垂综合征可能存在广泛的运动障碍。后颅窝和皮质下结构的机械变形导致这种运动异常的出现。SIH添加到导致“可治疗的运动障碍”的条件列表中。\"因此,运动障碍神经学家应熟悉这种疾病的诊断和临床特征。
UNASSIGNED: Spontaneous intracranial hypotension (SIH), a treatable condition that stems from spinal leakage of cerebrospinal fluid, usually presents with orthostatic headache, nausea, vomiting, dizziness, and tinnitus. A subset of patients, especially those with sagging of brain structures (\"brain sagging syndrome\"), develop several movement abnormalities. As SIH is treatable with epidural blood patch (EBP), movement disorders neurologists should be familiar with this syndrome.
UNASSIGNED: The authors performed a literature search in PubMed in July 2024 using the Boolean phrase- ((\"Brain sagging\")OR(\"Intracranial hypotension\"))AND((((((((((\"Movement disorders\")OR(\"Involuntary movements\"))OR(\"Tremor\"))OR(\"Dystonia\"))OR(\"Chorea\"))OR(\"Ballismus\"))OR(\"Myorhythmia\"))OR (\"Tic\"))OR(\"Ataxia\"))OR(\"Parkinsonism\")).
UNASSIGNED: We tabulated 21 case reports/series that highlighted the presence of movement disorders. The most reported phenomenology is gait unsteadiness. While it usually emerges in the background of the classic SIH symptoms, rarely, patients may present with isolated gait dysfunction. Tremor is the second most reported phenomenology with postural and kinetic tremor being the common subtypes. Holmes tremor has also been reported in SIH. Other reported phenomenologies are parkinsonism, chorea, and dystonia. One study reported a unique phenomenology i.e. compulsive repetitive flexion and breath holding in 35.3% of the patients. In majority of the patients, EBP resulted in substantial clinical and radiological improvement.
UNASSIGNED: Brain sagging syndrome due to SIH may present with a wide range of movement disorders. Mechanical distortion of the posterior fossa and subcortical structures result in the emergence of such movement abnormality. SIH adds to the list of conditions that result in \"treatable movement disorders.\" Therefore, movement disorders neurologists should be versed with the diagnosis and clinical features of this condition.