柏金遜綜合症

柏金遜綜合症(Parkinsonism)是和運動機能相關的臨床綜合症,其特徵是顫抖運動功能減退僵硬英語Rigidity (neurology)平衡障礙[1][2]。在柏金遜氏症(PD)患者身上會有類似徵狀(此綜合症因此而得名),而路易氏體腦退化症(DLB)、柏金遜症性腦退化症英語Parkinson's disease dementia(PDD)等疾病也會有此徵狀。這類綜合症的病因範圍很廣,包括神經退化障礙疾病、藥物、毒素代謝疾病,或是柏金遜氏症以外的神經性疾病[3]

柏金遜綜合症
Parkinsonism
病因
分類和外部資源
醫學專科神經學
ICD-118A00
ICD-10G21、​G22
DiseasesDB24212
MedlinePlus000759
Orphanet68402
[編輯此條目的維基數據]

病因

藥物引起

有柏金遜綜合症的人當中,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藥,特別是吩噻嗪(例如perphenazine及氯丙嗪)、噻噸英語thioxanthene(例如三氟噻噸英語flupenthixol珠氯噻醇英語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。藥物引起柏金遜綜合症的盛行率會隨年齡而上昇。藥物引起的柏金遜綜合症一但出現,多半會維持原有的程度,不像柏金遜氏症會漸漸惡化[4]

毒素

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

已證實慢性(Mn)暴露會造成類似柏金遜綜合症的疾病,其特徵是運動障礙,此徵狀無法用典型的柏金遜症治療方式英語Management of Parkinson's disease來治療,因此推測除了典型黑質多巴胺能損失外,包括有其他的致病途徑[6]。錳會在基底核內累積,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柏金遜綜合症疾病有關[8]。在這疾病中看不到柏金遜氏症中典型的路易體英語Lewy body[7]

診斷

許多疾病會造成柏金遜綜合症。

神經退化障礙柏金遜附加綜合症英語Parkinson plus syndrome[9]
藥物引發(偽柏金遜綜合症)
感染
毒素
創傷
血管的
其他

原發性震顫

根據2018年的回顧性研究,還不確定柏金遜綜合症和原發性震顫英語essential tremor是否有關[30]

參考資料

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外部連結