肢体抖动短暂性脑缺血发作二例

Clinical analysis of limb shaking transient ischemic attacks

目的探讨肢体抖动短暂性脑缺血发作的临床特点。方法分析本院神经内科2例肢体抖动短暂性脑缺血发作（ LS-TIA）患者的临床资料。结果2例患者均在60岁以后发病，临床表现为活动后肢体抖动、无力，休息后缓解。例1头颅MRA显示颅内动脉粥样硬化样改变，抖动肢体对侧血管大脑中动脉M2段轻度狭窄，同侧颈内动脉颅内段中度狭窄，前交通动脉中度狭窄；例2头颈CTA显示抖动肢体对侧颈内动脉起始部狭窄约70％～80％，大脑中动脉M1段起始部闭塞。例1患者视频脑电图（ VEEG）监测到3次肢体抖动发作，未发现异常癫痫波。2例患者在常规治疗下均给予扩容治疗以提高大脑血流灌注，发作次数均减少，1个月后其中1例进展为脑卒中。结论 LS-TIA是TIA的一种罕见的发作形式，应注意与局灶性运动性癫痫发作相区别，尽早诊断及提高大脑血流灌注可以减少发作或减低卒中发生的风险。

Objective To study the clinical manifestations and possible pathogenesis in two patients with limb shaking transient ischemic attacks （ LS-TIA ） .Methods We enrolled 2 patients with LS-TIA in neurology department .Results Two patients were in 60 years old later onset of the disease , with several years history of diabetes and high blood pressure , adhere to the antihypertensive therapy .The clinical manifestations was dithering after activities, weakness, they could alleviate after rest .1 cases of brain MRA display intracranial atherosclerosis , left internal carotid artery intracranial section moderate stenosis , left before the traffic a moderate stenosis , on the right side of the brain artery M 2 period of mild stenosis .1 cases of CTA showed：the right internal carotid artery initial department narrow about 70%-80%, on the right side of the brain artery M 1 period of initial department block .1 patients VEEG inspection did not see epilepsy wave , The management of improving cerebral blood flow , one case development as the stroke , an another reduced the attack .Conclusion Limb shaking is a rather uncommon form of TIA that should be recognized and differentiated from conditions like focal motor seizure .Moreover, a quick diagnosis is important both to abolish the attacks and reduce the risk of major stroke .