脑桥卒中与膈肌阵挛

Clinical study about the diaphragmatic myoclonus after pons stroke

目的分析脑桥卒中合并膈肌阵挛的特点及可能的机制。方法分析2006～2010年在南方医院神经内科住院治疗的11例脑桥卒中合并膈肌阵挛患者的临床资料。结果所有患者均在急性期出现阵发性膈肌阵挛,阵挛频率2～6 Hz,每次发作一般持续数分钟至数小时,均可自行缓解。所有患者行常规脑电图或长程脑电监测均未发现癎样放电。其中8例伴有顽固性呃逆,频率为0.2～0.5 Hz。结论脑桥卒中可以引起膈肌阵挛,预后较好,可能与中央被盖束损害导致"肌阵挛三角"环路受损有关。

Objective To study the clinical aspects and the possible mechanism of the diaphragmat- ic myoclonus after pons stroke. Methods The clinical data of the 11 patients,hospitalized in the neurological department of Nanfang Hospital from the year 2006 to 2010,were analyzed. Results All the patients suffered from the diaphragmatic myoclonus after pons stroke in the acute stage. The diaphragmatic myoclonus,whose attack generally lasted minutes to hours with the frequency of 2--6 Hz,could be alleviated spontaneously. Epileptic discharge was not observed in all of the patients with EEG or Long-range EEG. Intractable hiccup with the frequency of 0.2--0.5 Hz oc- curred in 8 cases. Conclusion The diaphragmatic myoclonus after pons stroke, possibly related with the impaired neural pathway of Guillain-Mollaret triangle resulted from the damage of the central tegmental tract,that has a relatively well outcome.