Perverted Head-Shaking and Positional Downbeat Nystagmus in Essential Tremor
Perverted Head-Shaking and Positional Downbeat Nystagmus in Essential Tremor
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DOI：
10.1007/s12311-015-0683-7
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发表时间：
2016-04-01
期刊：
影响因子：
3.5
通讯作者：
Jeon, Beom S.
中科院分区：
文献类型：
--
作者：
Kim, Young Eun;Kim, Ji Soo;Jeon, Beom S.
尽管其病理生理机制尚不完全清楚，小脑功能障碍已被认为是特发性震颤（ET）的病因。我们评估了ET小脑功能障碍与变态摇头（pHSN）和位置下拍性眼球震颤（pDBN）的存在，这是已知的小脑功能障碍的反映。首先，我们回顾了2007年3月至2010年4月185例ET患者的视频摄影（VOG）。28例pHSN和pDBN患者中的17例从基线开始随访至少1.8年，以确定临床病程。然后，我们招募了52名连续的ET患者，并将他们的眼运动结果与51名正常对照进行了VOG比较。185例ET患者中，28例（15.1%）表现为pHSN （n = 23, 12.4%）或pDBN （n = 8, 4.3%）。其中17人在观察期间没有出现帕金森病或其他神经功能缺陷。随后的病例对照研究显示，ET患者中pHSN或pDBN的患病率（11/52,21.2%，pHSN 9例，pDBN 5例）高于正常对照组（2/51,3.9%，仅pHSN， P = 0.015）。震颤等级量表或受累的身体部位在有和没有pHSN/pDBN的患者之间没有差异。ET患者中pHSN和pDBN比正常对照组更常见。这一结果支持小脑功能障碍与ET相关。
Even though the pathophysiology is not completely understood, cerebellar dysfunction has been invoked in essential tremor (ET). We evaluated cerebellar dysfunction in ET with the presence of perverted head-shaking (pHSN) and positional downbeat nystagmus (pDBN) which are known to reflect cerebellar dysfunction. First, we reviewed the videooculography (VOG) of 185 patients with ET from March 2007 to April 2010. Seventeen of 28 patients with pHSN and pDBN were followed up for at least a 1.8-year interval from baseline to determine the clinical course. And then, we recruited 52 consecutive patients with ET and compared their ocular motor findings with 51 normal controls using VOG. Among the 185 patients with ET, 28 (15.1 %) showed pHSN (n = 23, 12.4 %) or pDBN (n = 8, 4.3 %). Seventeen of them who were followed up did not develop Parkinsonism or other neurologic deficits during the observation period. The subsequent case-control study showed a higher prevalence of pHSN or pDBN (11/52, 21.2 %, pHSN in nine and pDBN in five) in patients with ET than in the normal controls (2/51, 3.9 %, pHSN only, P = 0.015). The tremor rating scale or involved body sites did not differ between the patients with and without pHSN/pDBN. pHSN and pDBN were more common in patients with ET than in the normal controls. This result supports that cerebellar dysfunction is associated with ET.