中国神经精神疾病杂志2024,Vol.50Issue(11) :675-677.DOI:10.3969/j.issn.1002-0152.2024.11.006

以帕金森综合征为主要表现的脊髓小脑性共济失调2型1例

Spinocerebellar ataxia type 2 with Parkinsonism as the main manifestation:a case report

刘马敬 王梁 刘轶卓 孙凡哲 刘居宜 邓金良 郝子焱 宋学琴
中国神经精神疾病杂志2024,Vol.50Issue(11) :675-677.DOI:10.3969/j.issn.1002-0152.2024.11.006

以帕金森综合征为主要表现的脊髓小脑性共济失调2型1例

Spinocerebellar ataxia type 2 with Parkinsonism as the main manifestation:a case report

刘马敬 1王梁 1刘轶卓 1孙凡哲 1刘居宜 1邓金良 1郝子焱 1宋学琴1
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作者信息

  • 1. 河北医科大学第二医院,石家庄 050000
  • 折叠

摘要

患者以"运动迟缓3年"就诊于我院神经内科,伴有静止性震颤和共济失调,查体可见左手对指时有越做越小的趋势,左侧握拳、脚趾拍地动作稍慢,左侧跟膝胫试验、轮替试验欠稳准,其父亲和大姐有类似表现.入院后完善泌尿系统彩超、膀胱残余尿等实验室检查,结果未见明显异常.颅脑MRI示左侧顶叶散在非特异性白质改变.左旋多巴负荷试验阳性.拟诊为帕金森综合征,考虑患者有家族史,行基因检测可见ATXN2基因CAG序列发生异常扩增,最终诊断为脊髓小脑共济失调2型(spinocerebellar ataxia 2,SCA2).经随访,患者目前症状平稳,无进展.提示临床中以帕金森综合征为主要表现伴有共济失调,且有家族史者要行基因检测,避免误诊、漏诊.

Abstract

The patient was diagnosed with "motor retardation for 3 years" in the neurology department of our hospital,accompanied by static tremors and ataxia. Physical examination showed that there was a tendency to decrease for amplitude of repetitive finger movements of the left hand and the left hand clenched fist and toe tapping movements were slightly slower. The left heel knee tibia test and rotation test were not accurate,and the father and elder sister had similar symptoms. After admission,laboratory tests such as urinary tract ultrasound and residual urine in the bladder were completed,and the tests did not reveal any significant abnormalities. Brain MRI shows scattered non-specific white matter changes in the left parietal lobe. Levodopa challenge test was positive. The patient was then suspected to have Parkinsonism. considering that the patient has a family history. Genetic testing was ordered and the results showed abnormal amplification of the ATXN2 gene CAG sequence. Therefore,the final diagnosis was spinocerebellar ataxia type 2. The patient's symptoms are stable and there is no progression during the follow-up. SCA2 should be considered in the case of Parkinsonism accompanied by ataxia and a family history to avoid misdiagnosis and missed diagnosis.

关键词

脊髓小脑性共济失调/帕金森综合征/ATXN2基因/CAG扩增/Ataxin-2蛋白/多聚谷氨酰胺疾病/左旋多巴负荷试验

Key words

Spinocerebellar ataxia/Parkinsonism/ATXN2 gene/CAG repeat expansion/Ataxin-2 protein/Polygl-utamine disease/Levodopa stress test

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出版年

2024
中国神经精神疾病杂志
中山大学

中国神经精神疾病杂志

CSTPCD北大核心
影响因子:1.38
ISSN:1002-0152
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