老年患者肢体抖动性短暂性脑缺血发作的临床分析

Clinical Analysis of Limb-shaking Transient Ischemic Attacks in Elderly Patients

目的肢体抖动性短暂性脑缺血发作(Limb-Shaking Transient Ischemic Attacks,LS-TIA)是临床很少见的短暂性脑缺血发作发作类型,通过探讨老年患者LS-TIA的临床特点,提高临床医生对本病的认识。方法回顾性分析我院2012年至2016年年间诊治的9例老年LS-TIA患者的临床资料。结果 9例患者均表现为肢体发作性短暂性不能控制的抖动,6例发作有明显诱因。所有患者均有抖动肢体对侧至少1条以上颅内和(或)颅外动脉的严重狭窄或闭塞,所有患者发作期脑电图检查均未见癫痫样波。经扩容、抗血小板聚集、血管重建术等治疗后,症状均消失,8例患者病情稳定。结论低灌注是LS-TIA可能的发病机制,LS-TIA通常提示大血管严重狭窄或闭塞,扩容、抗栓或血管重建术是其有效的治疗方法。

Objective Limb-Shaking Transient Ischemic Attacks（ LS-TIA） is a rare clinical seizure type transient ischemic attack.To improve the clinician＇s understanding of the disease through investigating the clinical characteristics of LS-TIA in elderly patients. Methods The clinical data of 9 cases of elderly patients with LS-TIA treated in our hospital from 2012 to 2016 were analyzed retrospectively. Results All of the 9 patients presented with episodic,transient,and non controllable shaking,and6 of them had a distinct cause of attack.All patients had severe stenosis or occlusion of at least 1 intracranial and/or extracranial arteries on the contralateral side of the shaking limb,and no epileptiform waves were detected in all ictal EEG examinations. The symptoms disappeared after treatment such as dilatation,antiplatelet therapy,revascularization,and so on,and 8 patients were stable. Conclusion Hypoperfusion is the possible pathogenesis of LS-TIA,which usually indicates severe stenosis or occlusion of the large vessels. And dilation,antithrombotic,or revascularization are effective therapies.