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帕金森症候群

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帕金森症候群
Parkinsonism
Sir William Richard Gowers Parkinson Disease sketch 1886.svg
醫學專科 神經學
肇因

帕金森症候群(Parkinsonism)是和運動機能相關的臨床症候群,其特徵是顫抖運動功能減退僵硬英语Rigidity (neurology)平衡障礙英语balance disorder[1][2]。在帕金森氏症(PD)患者身上會有類似症狀(此症候群因此而得名),而路易氏體失智症(DLB)、帕金森病性失智症英语Parkinson's disease dementia(PDD)等疾病也會有此症狀。這類症候群的病因範圍很廣,包括神經退化障礙疾病、藥物、毒素代謝疾病,或是帕金森氏症以外的神經性疾病[3]

病因[编辑]

藥物引起[编辑]

有帕金森症候群的人當中,約有7%是因為藥物的副作用而造成的,主要是因為抗精神病药,特別是吩噻嗪(例如perphenazine及氯丙嗪)、噻噸英语thioxanthene(例如三氟噻噸英语flupenthixol珠氯噻醇英语zuclopenthixol)及丁酰苯(例如氟哌啶醇),偶爾也有因為抗憂鬱藥物而造成。藥物引起帕金森症候群的盛行率會隨年齡而上昇。藥物引起的帕金森症候群一但出現,多半會維持原有的程度,不像帕金森氏症會漸漸惡化[4]

毒素[编辑]

有發現殺蟲劑或除草劑暴露程度和帕金森氏症之間的關聯性。若暴露在百草枯錳乃浦英语Maneb/鋅錳乃浦英语Mancozeb下,風險是原來的兩倍[5]

已證實慢性(Mn)暴露會造成類似帕金森症候群的疾病,其特徵是運動障礙[6],此症狀無法用典型的帕金森症治療方式英语Management of Parkinson's disease來治療,因此推測除了典型黑质多巴胺能損失外,包括有其他的致病途徑[6]。锰會在基底核內累積,因此造成運動障礙[7]有一種和SLC30A10基因(錳外流轉運蛋白,減少細胞內錳所必需的蛋白)有關的變異和這種類似帕金森症候群疾病有關[8]。在這疾病中看不到帕金森氏症中典型的路易體英语Lewy body[7]

診斷[编辑]

許多疾病會造成帕金森症候群。

神經退化障礙巴金森附加症候群英语Parkinson plus syndrome[9]
藥物引發(偽帕金森症候群)
感染
毒素
創傷
血管的
其他

原發性震顫[编辑]

根據2018年的回顧性研究,還不確定帕金森症候群和原發性震顫英语essential tremor是否有關[30]

參考資料[编辑]

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