发作性运动诱发性运动障碍研究进展

Recent advances of paroxysmal kinesigenic dyskinesia

发作性运动诱发性运动障碍（PKD）是发作性运动障碍中最常见的一种,发病诱因为突然运动或惊吓.临床表现包括发作性单侧或双侧舞蹈样动作,手足徐动,肌张力障碍或投掷症等,发作期意识清晰.PKD分家族性和散发性,其中家族性PKD呈常染色体显性遗传,并伴有外显子不全.最近几年的研究已将PKD致病区域定位在16p1 1.2-q12.1及16q13-q22.1,但也有学者提出了第3个致病区域.PRRT2基因最近被认为是PKD的致病基因,但PRRT2定位于16p12.1,其他区域是否也存在致病基因有待进一步的研究.PKD的病理生理机制目前尚不清楚,其致病基因PRRT2突变后对蛋白功能的影响亦不明确.现综合研究进展,为临床诊断和治疗提供帮助.

Paroxysmal kinesigenic dyskinesia （PKD） is the most frequently described subtype of paroxysmal dyskinesias.The precipitating factor is usually sudden movement or startle.Clinically,PKD cases suffer involuntary movements including unilateral or bilateral chorea,athetosis,dystonia or ballismus,with preserved consciousness.Family history is commonly noted in idiopathic PKD,but sporadic cases are also reported.Familial PKD is inherited in an autosomal dominant fashion with incomplete penetrance.To date,2 loci 16p11-q12 and 16q13-q22 have been mapped to PKD,although a 3rd locus is also suspected.PRRT2,which was located in 16p12.1,was recently identified as causative gene of PKD.However,culprit genes in the other 2 loci remain to be investigated.The potential mechanism of PKD remains largely unclear and the role of mutant PRRT2 in the pathogenesis of PKD is still unknown.In this review,the recent advances of PKD were summarized and hypothesis regarding the mechanisms of PKD was put up,which may make significant contributions to the diagnosis and treatment of PKD.