Paroxysmal movement disorders.

Q2 Medicine
Francesca Magrinelli, Kailash P Bhatia
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引用次数: 0

Abstract

Paroxysmal movement disorders include two groups of intermittent neurologic disorders: paroxysmal dyskinesia, in which episodes of involuntary hyperkinetic movements (mainly chorea and/or dystonia) occur with preserved consciousness, and episodic ataxias, which are characterized by discrete attacks of cerebellar dysfunction, sometimes associated with progressive ataxia. Since episodic ataxias are individually discussed in Chapter 8 of this volume, we herein provide a deep overview of phenotypic, genetic, pathophysiologic, diagnostic, and treatment aspects of paroxysmal dyskinesia, following the trigger-based nomenclature which distinguishes paroxysmal kinesigenic dyskinesia, paroxysmal nonkinesigenic dyskinesia, and paroxysmal exercise-induced dyskinesia. Emerging paroxysmal dyskinesia not fulfilling the criteria for the above-mentioned subtypes will also be discussed. Phenotypic and genotypic overlap among paroxysmal movement disorders, epilepsy, and migraine have progressively emerged, thus shedding light on a shared pathophysiologic framework. Advances in our understanding of the pathomechanisms underlying paroxysmal movement disorders, which involve dysfunctions of ion channels, proteins associated with the vesical synaptic cycle machinery, and proteins involved in neuronal energy metabolism, point toward a discrete number of converging pathophysiologic pathways and may lay foundations for developing target-specific therapies.

阵发性运动障碍
阵发性运动障碍包括两类间歇性神经系统疾病:阵发性运动障碍(paroxysmal dyskinesia)和发作性共济失调(episodic ataxias),前者是指发作性不自主过度运动(主要是舞蹈症和/或肌张力障碍),但意识保持清醒;后者的特征是小脑功能障碍的离散发作,有时伴有进行性共济失调。本卷第 8 章对发作性共济失调进行了单独讨论,因此我们在此对阵发性运动障碍的表型、遗传、病理生理学、诊断和治疗等方面进行深入概述,并采用基于触发因素的命名法对阵发性运动源性运动障碍、阵发性非运动源性运动障碍和阵发性运动诱发性运动障碍进行区分。此外,还将讨论不符合上述亚型标准的新出现的阵发性运动障碍。阵发性运动障碍、癫痫和偏头痛之间的表型和基因型重叠已逐渐显现,从而揭示了一个共同的病理生理学框架。阵发性运动障碍的病理机制涉及离子通道、与膀胱突触周期机制相关的蛋白质以及参与神经元能量代谢的蛋白质的功能障碍,我们对这些病理机制的认识取得了进展,从而发现了一些相互关联的病理生理途径,并为开发靶向特异性疗法奠定了基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Handbook of clinical neurology
Handbook of clinical neurology Medicine-Neurology (clinical)
CiteScore
4.10
自引率
0.00%
发文量
302
期刊介绍: The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.
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