Movement Disorders in Brain Sagging Syndrome Due To Spontaneous Intracranial Hypotension: A Review.

IF 2.5 Q2 CLINICAL NEUROLOGY
Tremor and Other Hyperkinetic Movements Pub Date : 2024-09-06 eCollection Date: 2024-01-01 DOI:10.5334/tohm.914
Abhigyan Datta, Alfonso Fasano, Abhishek Lenka
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引用次数: 0

Abstract

Background: 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.

Method: 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")).

Result: 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.

Discussion: 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.

自发性颅内低血压所致脑下垂综合征的运动障碍:综述。
背景:自发性颅内低血压(SIH)是一种可治疗的疾病,源于脊髓脑脊液漏,通常表现为正压性头痛、恶心、呕吐、头晕和耳鸣。一部分患者,尤其是脑结构下垂的患者("脑下垂综合征"),会出现多种运动异常。由于 SIH 可通过硬膜外血补片(EBP)治疗,因此运动障碍神经科医生应熟悉这种综合征:作者于 2024 年 7 月在 PubMed 上进行了文献检索,使用的布尔短语为(("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"))).结果:我们以表格形式列出了 21 个强调存在运动障碍的病例报告/系列。报告最多的现象是步态不稳。虽然步态不稳通常出现在典型 SIH 症状的背景中,但在极少数情况下,患者可能会出现孤立的步态功能障碍。震颤是报告第二多的现象,姿势性震颤和运动性震颤是常见的亚型。SIH 中也有霍姆斯震颤的报道。其他报告的现象还有帕金森氏症、舞蹈症和肌张力障碍。一项研究报告了一种独特的现象,即 35.3% 的患者出现强迫性重复屈曲和屏气。在大多数患者中,EBP 可使临床和放射学症状得到显著改善:讨论:由 SIH 引起的脑下垂综合征可表现为多种运动障碍。后窝和皮层下结构的机械变形导致了此类运动异常的出现。SIH 增加了导致 "可治疗运动障碍 "的疾病清单。因此,运动障碍神经科医生应熟悉这种疾病的诊断和临床特征。
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
CiteScore
4.00
自引率
4.50%
发文量
31
审稿时长
6 weeks
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