背景:Opalski综合征,延髓外侧综合征(LMS)的亚型,由于其不同的临床表现和潜在的非典型症状,提出了挑战。了解其流行病学,临床表现,结果对于优化患者护理至关重要。
方法:系统综述,遵循PRISMA2020指导方针,进行了全面分析Opalski综合征。数据来自PubMed,Scopus,WebofScience,包括Embase,搜索于2023年5月进行。纳入病例报告的合格研究,案例系列,和编辑信。
结果:该综述涵盖了1984年至2024年的78项研究,涉及94例Opalski综合征患者。分析显示男性占主导地位(76.60%),男女比例为3.1:1。常见的危险因素包括高血压(63.54%),糖尿病(32.29%),吸烟(32.39%),和酒精消费量(22.91%)。在5大洲的22个国家报告了Opalski综合征病例,亚洲是最普遍的地区(77.08%)。最初的表现通常包括共济失调或手指到鼻子和膝盖到脚跟测试阳性,头晕或眩晕,偏瘫,眼球震颤,霍纳的标志,第五或第七脑神经麻痹,都发生在50%以上的病例中。磁共振成像(MRI)和磁共振血管造影(MRA)等神经影像学技术对于诊断至关重要。尽管死亡率为4.16%,自2014年以来没有死亡报告,这表明临床管理取得了进步.
结论:目标风险因素管理,早期识别症状,和利用先进的神经成像技术对于优化患者预后至关重要。临床医生必须保持对Opalski综合征的了解,以提高诊断准确性并调整治疗策略。
BACKGROUND: Opalski syndrome, a subtype of lateral medullary syndrome (LMS), poses challenges due to its diverse clinical presentations and potential atypical symptoms. Understanding its epidemiology, clinical manifestations, and outcomes is crucial for optimizing patient care.
METHODS: A systematic
review, following PRISMA 2020 guidelines, was conducted to comprehensively analyze Opalski syndrome. Data from PubMed, Scopus, Web of Science, and Embase were included, with the search conducted in May 2023. Eligible studies spanned from included case reports, case series, and editorial letters.
RESULTS: The
review encompassed 78 studies from 1984 to 2024, involving 94 patients with Opalski syndrome. The analysis revealed a male predominance (76.60 %) with a male-to-female ratio of 3.1:1. Common risk factors included hypertension (63.54 %), diabetes mellitus (32.29 %), smoking (32.39 %), and alcohol consumption (22.91 %). Opalski syndrome cases were reported in 22 countries across 5 continents, with Asia being the most prevalent region (77.08 %). Initial presentations commonly included ataxia or positive finger-to-nose and knee-to-heel tests, dizziness or vertigo, hemiparesis, nystagmus, Horner\'s sign, and 5th or 7th cranial nerve palsy, all occurring in more than 50 % of cases. Neuroimaging techniques such as magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) were crucial for diagnosis. Despite a mortality rate of 4.16 %, no deaths have been reported since 2014, indicating advancements in clinical management.
CONCLUSIONS: Targeted risk factor management, early recognition of symptoms, and utilization of advanced neuroimaging techniques are essential for optimizing patient outcomes. Clinicians must remain informed about Opalski syndrome to enhance diagnostic accuracy and tailor treatment strategies.