• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The Internet Journal of Neurology >An Elderly Lady with Parkinsonism
【24h】

An Elderly Lady with Parkinsonism

机译：帕金森病的老年妇女

获取原文
       
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Parkinsonism is a syndrome consisting of variable combination of tremor, rigidity, bradykinesia and a characteristic disturbance of gait and posture. It may be caused by many etiological factors and is an important cause of neurological disability in the elderly population. Symptoms of Parkinson's disease are caused by loss of nerve cells in the pigmented substantia nigra pars compata and the locus coeurulus in the mid brain. Loss of dopaminergic cells in the substantia nigra leads to striatal dopamine depletion. This results in reduced thalamic excitation of the motor cortex. The exact etiology of Parkinson's disease is not known but exposure to many toxic substances also can lead to this clinical picture. We are reporting here a case of delayed neurological sequelae of carbon monoxide poisoning, with Parkinsonism as the predominant clinical feature and excellent response to treatment with Levodopa and Bromocriptine. Introduction Carbon monoxide (CO) is a great imitator1. The symptoms of Carbon monoxide poisoning are vague and varied and providing insufficient treatment can lead to neurological sequelae. Common source of carbon monoxide is smoke from any type of fire. It produces toxicity by five mechanisms1. Directly binding carbon monoxide to hemoglobin Shifting the oxygen – hemoglobin dissociation curve Carbon monoxide binding to myoglobin Carbon monoxide binding to cytochrome oxidase system Brain lipid peroxidation A syndrome of delayed neurological sequelae can occur with appearance of symptoms within 2 to 3 weeks of acute exposure in 10 to 30% cases2. These are common in patients with decreased levels of consciousness at the time of emergency room evaluation and those who develop hypotension during hypoxic period3 and older patients. The most common symptoms are cognitive dysfunction, urinary and fecal incontinence and gait disturbance. Other symptoms include memory loss, disinhibition, disorientation, plasticity, rigidity, aphasia and personality changes. Complete recovery occurs in two third of cases1. Parkinsonism is a recognized complication of carbon monoxide poisoning which has been described to occur from 3 to 240 days after exposure4 but the reported incidents varies widely 5,6,7. We are reporting here a lady who presented with delayed neurological complications of carbon monoxide poisoning in the form of Parkinsonism and responded well to treatment with levodopa and bromocriptine. Case Report A 65-year-old Yemeni lady was admitted with inability to move the limbs, inability to speak and eat since two days. The patient was treated elsewhere for Carbon Monoxide poisoning one month before coming to our hospital. Both she and her husband were sleeping in a closed room when the fire happened. Her husband died during the episode. She did not improve after treatment in the local hospital and sought medical help in Saudi Arabia. She gave past history of diabetes and hypertension which were poorly controlled. On examination the patient was conscious but dysphasic, BP – 150/110 mm Hg. Neurological examination revealed right-sided weakness. CT scan of Brain (Figure 1) was reported normal showing only age-related changes.
机译：帕金森综合症是一种综合症，由震颤，僵硬，运动迟缓和典型的步态和姿势障碍组成。它可能是由许多病因引起的，并且是老年人神经系统残疾的重要原因。帕金森氏病的症状是由色素沉着的黑质compata中的神经细胞丢失和大脑中部的脉动斑引起的。黑质中多巴胺能细胞的损失导致纹状体多巴胺的消耗。这导致运动皮层的丘脑激发减少。帕金森氏病的确切病因尚不清楚，但接触许多有毒物质也会导致这种临床症状。我们在此报告一例一氧化碳中毒的迟发性神经系统后遗症，其中帕金森氏症为主要临床特征，对左旋多巴和溴隐亭的治疗反应良好。简介一氧化碳（CO）是一个很好的模仿者。一氧化碳中毒的症状含糊不清，种类繁多，治疗不足会导致神经系统后遗症。一氧化碳的常见来源是任何类型的火灾产生的烟雾。它通过五种机制产生毒性1。一氧化碳与血红蛋白直接结合移动氧-血红蛋白的解离曲线一氧化碳与肌红蛋白结合一氧化碳与细胞色素氧化酶系统结合脑脂质过氧化急性暴露后2至3周内可出现延迟性神经后遗症，并出现症状占30％2。这些常见于急诊室评估时意识水平降低的患者以及在低氧时期3和年龄较大的患者中发生低血压的患者。最常见的症状是认知功能障碍，尿和大便失禁和步态障碍。其他症状包括记忆力减退，抑制力，迷失方向，可塑性，僵硬，失语和性格改变。在三分之二的情况下会完全恢复1。帕金森病是一氧化碳中毒的公认并发症，已被描述为在暴露后3到240天发生4，但报告的事件差异很大5,6,7。我们在这里报告一位女士，她以帕金森病的形式出现一氧化碳中毒的迟发性神经系统并发症，并且对左旋多巴和溴隐亭的治疗反应良好。病例报告一名65岁的也门女士因四天无力，四肢无语和进食而入院。该患者在来我们医院的一个月前因一氧化碳中毒而在其他地方接受治疗。火灾发生时，她和丈夫都在封闭的房间里睡觉。她的丈夫在情节中去世。她在当地医院接受治疗后并没有好转，并在沙特阿拉伯寻求医疗帮助。她讲述了过去控制不佳的糖尿病和高血压病史。检查时，患者意识清醒但吞咽困难，血压– 150/110 mm Hg。神经系统检查显示右侧无力。据报道大脑的CT扫描（图1）正常，仅显示与年龄相关的变化。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号