星状神经节阻滞治疗难治性周期性肢体运动障碍1例。

IF 4.8 2区 医学 Q1 CLINICAL NEUROLOGY
Aaron Burshtein, Vineet Aggarwal, Jung H Kim
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引用次数: 0

摘要

目的:周期性肢体运动障碍(PLMD)涉及睡眠期间上肢/下肢的周期性、刻板运动。本体脊髓肌阵挛(PSM)包括重复的、不规则的、肌阵挛性抽搐,始于胸中区域,并通过本体脊髓通路传播到邻近的节段。介入方式的证据有限。本报告讨论了星状神经节阻滞(SBG)在PLMD中的应用。方法:回顾1例因PLMD接受SGB治疗的患者记录。结果:我们报告一例用SGB成功治疗难治性PLMD的病例。讨论:这个病例显示了复杂的PLMD,对许多治疗方法都是难治的。然而,SGB被证明可以显著改善患者的夜间痉挛疼痛。PLMD的标志是上肢和下肢的肌阵挛运动,被认为是由于本体脊髓神经元的过度活跃。星状神经节被认为是交感神经系统激活的来源,用局部麻醉剂阻断该神经节可减少交感神经活动。以前没有描述过PLMD的SGB。然而,我们的研究结果表明,由于本体脊髓中间神经元的可塑性,运动神经元和交感神经系统之间的交流是可能的。虽然SBG的适应症正在迅速扩大,但其在PLMD中的应用确实是新颖的。迫切需要进一步的研究来建立SGB作为PLMD的固体治疗方式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Stellate ganglion block for refractory periodic limb movement disorder: case report.

Objectives: Periodic limb movement disorder (PLMD) involves periodic, stereotypic movements of upper/lower extremities during sleep. Propriospinal myoclonus (PSM) involves repetitive, irregular, myoclonic jerks starting in the midthoracic region and propagating to adjacent segments through propriospinal pathways. Limited evidence exists for interventional modalities. This report discusses the utility of stellate ganglion block (SBG) for PLMD.

Methods: A review of one patient record who underwent SGB for PLMD.

Results: We present a case of successful treatment of refractory PLMD with SGB.

Discussion: This case demonstrates complicated PLMD that was refractory to numerous treatment modalities. However, SGB was shown to significantly improve the patient's painful nocturnal spasms. The hallmark of PLMD is myoclonic movement of upper and lower extremity thought to be due to hyperactivity of propriospinal neurons. The stellate ganglion is thought to be the source of a sympathetic nervous system activation and blocking the ganglion with local anesthetic reduces sympathetic activity. SGB for PLMD has not been previously described. However, our results indicate that communication between motor neurons and sympathetic nervous system is possible due to the plasticity of propriospinal interneurons. While the indication for SBG is rapidly expanding, its application for PLMD is truly novel. Further research is desperately needed to establish SGB as a solid treatment modality for PLMD.

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来源期刊
Journal of Neurology
Journal of Neurology 医学-临床神经学
CiteScore
10.00
自引率
5.00%
发文量
558
审稿时长
1 months
期刊介绍: The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.
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