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首页> 外文期刊>Journal of neurology >Dropped head in Parkinson's disease.
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Dropped head in Parkinson's disease.

机译：帕金森氏病低落。

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"A propensity to bend the trunk forward" and "the chin is now almost immovably bent down upon the sternum" were described by James Parkinson in patients with Parkinson's disease (PD). The term "dropped head" was first reported in "Gerlier disease" in Switzerland and 'kubisagari' in Japan and since then also reported in myositis, myopathy, myasthenia gravis, amyotrophic lateral sclerosis, neuropathy, and hypothyroidism. Disproportionate antecollis occurs in about half cases of multiple system atrophy (MSA) and is considered dystonic in nature. Dropped head is considered rare in PD, both in advanced and early stages of PD. However, it is known to progress subacutely over a period of several days. In my experience, dropped head is relatively common in PD. The mechanism of dropped head in PD is either dystonia of flexor neck muscles or weakness of extensor neck muscles. The response of dropped head to various anti-parkinsonian medications is rather inconsistent. Levodopa is reported to induce amelioration in some patients while dopamine agonists can cause deterioration. Muscle afferent block with lidocaine and ethanol is reported to be effective, while the effect of botulinum toxin injection into the affected muscles is limited. The effect of stereotaxic neurosurgery on dropped head is controversial. Early diagnosis and prompt treatment is necessary to prevent muscle damage associated with longterm overstretch of extensor neck muscles.
机译：James Parkinson在帕金森氏病（PD）患者中描述了“向前弯曲躯干的倾向”和“下巴现在几乎不可动地向胸骨弯曲”。 “掉头”一词最早在瑞士的“杰里尔病”和日本的“ kubisagari”中报道，此后在肌炎，肌病，重症肌无力，肌萎缩性侧索硬化，神经病和甲状腺功能减退症中也有报道。不成比例的前泡发生在多系统萎缩（MSA）的大约一半病例中，本质上被认为是肌张力障碍。在PD的晚期和早期，头部掉落在PD中被认为是罕见的。但是，已知它会在几天内亚急性发展。以我的经验，在PD中，掉头比较常见。 PD掉头的机制可能是颈部屈肌肌张力障碍或伸肌颈部肌无力。头部跌落对各种抗帕金森病药物的反应相当不一致。据报道，左旋多巴在某些患者中引起改善，而多巴胺激动剂可引起恶化。据报道，用利多卡因和乙醇阻止肌肉传入是有效的，而将肉毒杆菌毒素注射到受影响的肌肉中的作用是有限的。立体定向神经外科手术对跌落头部的影响是有争议的。早期诊断和及时治疗对于防止与伸肌颈部肌肉长期过度伸展有关的肌肉损害是必要的。

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