原发性进行性冻结步态

Primary progressive freezing gait

目的提高临床医师对原发性进行性冻结步态的认识。方法对1例79岁的原发性进行性冻结步态的患者随访2年8个月,并对临床资料进行总结分析。结果患者主要表现为间断性的冻结步态,未发现其他神经系统的阳性体征。对多巴胺能药物无反应。实验室检查未见异常。头颅MRI提示多发性腔隙性脑梗死,多巴胺转运体检查提示:两侧尾状核放射性分布略低,双侧壳核CFT显影剂放射性分布明显降低。结论此患者的临床表现符合原发性进行性冻结步态的诊断标准,多巴胺转运体检查结果为阳性,需进一步随访观察。

Objective To improve knowledge of primary progressive freezing gait（PPFG） in clinicians. Methods Thirty-two month-follow-up study was carried out for a 79-year-old man with PPFG. The patient was studied with general physical examination, MRI and dopamine transporter-PETCT（DAT-PETCT） in detail. Results The main symptom was intermittent freezing of gait without other positive signs of nervous system. He did not respond to dopaminergic drugs. Routine laboratory examinations did not find any abnormality. Brain MRI showed multiple lacunar infarcts. DAT-PETCT showed slight reduction of radioactivity in caudate nuclei of both sides and marked reduction of CFT radioactivity in putamen of both sides. Conclusion The clinical manifestations conform to diagnostic criteria of PPFG, but DAT examination is out of accord with other reports, so further follow-up survey is necessary.