The diagnosis of manganese-induced parkinsonism
The diagnosis of manganese-induced parkinsonism
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DOI：
10.1016/j.neuro.2005.10.006
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发表时间：
2006-05-01
期刊：
影响因子：
3.4
通讯作者：
Koller, William C.
中科院分区：
文献类型：
--
作者：
Cersosimo, Maria G.;Koller, William C.
帕金森病是一种临床综合征，除了各种非运动性症状外，还包括震颤、运动迟缓、僵硬、步态、平衡问题。帕金森氏症的病因有很多，如神经退行性疾病、药物、血管原因、结构病变、感染和毒物。帕金森病，或特发性帕金森病，是临床上观察到的最常见的帕金森病。黑质致密部变性，导致纹状体多巴胺丢失。帕金森病是一种缓慢进展的疾病，对左旋多巴治疗有显著和持续的反应。锰是一种必需的微量元素，可能与神经毒性有关。高质性可以发生在各种临床环境中。锰中毒的临床症状包括非特异性主诉、神经行为改变、帕金森病和肌张力障碍。虽然苍白球是损伤的主要结构，但其他基底神经节区域也可能受累。核磁共振扫描可以显示在暴露期间（以及暴露后的短时间内）苍白球的变化。氟多巴PET扫描评估黑质完整性。多巴胺能系统异常然而，在锰诱发的帕金森病的研究中，这些扫描再次报告是正常的。锰所致的帕金森病可能具有一些在帕金森病中不常见的临床特征，如运动性震颤、肌张力障碍、特异性步态障碍以及早期的精神、平衡和语言改变。临床症状往往是双侧的，而帕金森氏症开始于身体的一侧。锰诱发的帕金森病患者发病时可能比帕金森病患者更年轻。最后，在锰诱导的帕金森症中，左旋多巴治疗似乎缺乏反应。总之，通过临床和影像学研究可以区分锰诱导的帕金森病和帕金森病。(c) 2005爱思唯尔公司版权所有。
Parkinsonism is a clinical syndrome consisting of tremor, bradykinesia, rigidity, gait, balance problems, in addition to various non-motor symptoms. There are many causes of parkinsonism such as neurodegenerative disease, drugs, vascular causes, structural lesions, infections, and toxicants. Parkinson's disease, or idiopathic parkinsonism, is the most common form of parkinsonism observed in the clinic. There is degeneration of the substantia nigra, pars compacta, which results in loss of striatal dopamine. Parkinson's disease is a slowly progressive condition in which there is a dramatic and sustained responsiveness to levodopa therapy. Manganese is an essential trace element that can be associated with neurotoxicity. Hypermanganism can occur in a variety of clinical settings. The clinical symptoms of manganese intoxication include non-specific complaints, neurobehavioral changes, parkinsonism, and dystonia. Although the globus pallidus is the main structure of damage, other basal ganglia areas can also be involved. MRI scans may show globus pallidus changes during (and for a short period after) exposure. Fluorodopa PET scans that assess the integrity of the substantia nigra. dopaminergic system are abnormal in Parkinson's disease. However, these scans re-reported to be normal in a few cases studied with manganese-induced parkinsonism. The parkinsonism due to manganese may have some clinical features that occur less commonly in Parkinson's disease, such as kinetic tremor, dystonia, specific gait disturbances, and early mental, balance and speech changes. The clinical signs tend to be bilateral whereas Parkinson's disease begins on one side of the body. Patients with manganese-induced parkinsonism may be younger at the onset of the disease than with Parkinson's disease. Lastly, there appears to be a lack of response to levodopa therapy in manganese-induced parkinsonism.In summary it may be possible to differentiate manganese-induced parkinsonism from Parkinson's disease using clinical and imaging studies. (c) 2005 Elsevier Inc. All rights reserved.