背景:亚急性硬化性全脑炎(SSPE)是麻疹的并发症,在4-10年的潜伏期后发生。尽管据报道发达国家正在复苏,但发展中国家仍继续发生这种情况。特征包括进行性神经精神问题,肌阵鸣,癫痫发作,运动障碍和视力障碍。脑电图(EEG)通常显示周期性的全身放电,和脑脊液抗麻疹抗体升高是诊断。运动障碍越来越被认为是临床频谱的一部分,范围从运动过度(舞蹈病,肌张力障碍,震颤,抽搐)运动减退(帕金森病)障碍和共济失调。
目的:本文旨在全面回顾与SSPE相关的运动障碍。
方法:于2023年12月在PubMed和EMBASE数据库中进行了文献检索,并确定了文章以供审查。
结果:SSPE报告的运动障碍包括运动过度(舞蹈病,肌张力障碍,震颤和抽搐),运动减退(帕金森病),共济失调和眼外运动障碍。肌阵鸣,核心临床特征,是最常见的“异常运动”。在所有临床阶段都观察到运动障碍,也可能是一个展示功能,甚至没有肌阵鸣.多动性运动障碍比低动性运动障碍更常见。观察到运动障碍的演变,共济失调,舞蹈病和肌张力障碍发生较早,和帕金森病的后期。运动障碍的神经放射学相关性仍不清楚。
结论:在SSPE的临床阶段观察到广泛的运动障碍。大多数数据来自病例报告和小病例系列。需要进行多中心纵向研究,以更好地描绘SSPE中运动障碍的频谱和演变。
BACKGROUND: Subacute sclerosing panencephalitis (SSPE) is a complication of measles, occurring after a latency of 4-10 years. It continues to occur in developing countries although resurgence is being reported from developed countries. Characteristic features include progressive neuropsychiatric issues, myoclonus, seizures, movement disorders and visual impairment. Electroencephalography (EEG) typically shows periodic generalized discharges, and elevated CSF anti-measles antibodies are diagnostic. Movement disorders are being increasingly recognized as part of the clinical spectrum, and range from hyperkinetic (chorea,
dystonia, tremor, tics) to hypokinetic (parkinsonism) disorders and ataxia.
OBJECTIVE: This article aims to comprehensively
review the spectrum of movement disorders associated with SSPE.
METHODS: A literature search was conducted in PubMed and EMBASE databases in December 2023 and articles were identified for
review.
RESULTS: Movement disorders reported in SSPE included hyperkinetic (chorea,
dystonia, tremor and tics), hypokinetic (parkinsonism), ataxia and extraocular movement disorders. Myoclonus, a core clinical feature, was the most frequent \"abnormal movement.\" Movement disorders were observed in all clinical stages, and could also be a presenting feature, even sans myoclonus. Hyperkinetic movement disorders were more common than hypokinetic movement disorders. An evolution of movement disorders was observed, with ataxia, chorea and
dystonia occurring earlier, and parkinsonism later in the disease. Neuroradiological correlates of movement disorders remained unclear.
CONCLUSIONS: A wide spectrum of movement disorders was observed throughout the clinical stages of SSPE. Most data were derived from case reports and small case series. Multicentric longitudinal studies are required to better delineate the spectrum and evolution of movement disorders in SSPE.