青少年型帕金森病的临床特征

Clinical features of juvenile Parkinson's disease

目的 探讨青少年型帕金森病 (PD)的临床特征。方法 对 2 8例青少年型PD患者的临床资料进行回顾性分析。结果 2 8例中 5例有家族史 ,呈常染色体隐性遗传 (AR JP) ;症状轻、病程长 ,症状常左右不对称 ,腱反射活跃和症状波动较常见 ;头部CT或MRI检查一般正常 ;对多巴制剂反应良好 ,但其所诱发的症状波动出现早。与散发性PD患者相比 ,AR JP患者发病年龄更早 ,为 (2 0 6± 5 6 8)岁 ,病程更长 ,为 (9 5±5 77)年 ,而病情较轻、症状波动和腱反射活跃更多见 ,多巴制剂不良反应更常见。结论 青少年型PD具有独特的临床特征 ,可能是一个独立的疾病实体。AR JP与散发性青少年型PD临床特征不同 ,提示二者可能具有不同的发病机制。

Objective To explore the clinical features of juvenile Parkinson's disease(PD).Methods The clinical materials in 28 patients with juvenile Parkinsonism were analysed retrospectively.Results Among the 28 cases, 5 patients from 3 families had familial history and presented autosomal recessive inheritance(AR-JP).The sympotoms of the parkinsonian triad were mild and unsymmetric.The disease progressed slowly.Hyperreflexia and diurnal fluctuation of sympotoms were often seen in these patients,but brain CT and MRI were often nomal.Response to levodopa was satisfactory,but dopa-induced motor fluctuations occurred early. In contrast to sporadic juvenile PD,AR-JP tended to have earlier age of onset( 20.6±5.68 years),longer duration of progression of parkinsonian signs and symptoms( 9.5±5.77 years),more frequent presence of hyperreglexia and diural fluctuation,and more frequent appearance of dopa-related motor fluctuations.Conclusion The clinical features of patients with juvenile PD are peculiar and juvenile PD may be an independent disease entity.AR-JP is different from sporadic juvenile PD,which suggests that there may be different pathogenesis between these two subtypes.