解放军医学杂志2018，Vol.43Issue(3)：229-233,5.DOI:10.11855/j.issn.0577-7402.2018.03.09
卒中后打哈欠致肱肌运动倒错的临床及影像学特点分析
Clinical and radiological characteristics of hemiplegic arm raising related to yawning in stroke patient
李剑勇 1武雷 2崔芳 1孙柳青 2熊建美1
作者信息
- 1. 572000 海南三亚 解放军总医院海南分院神经内科
- 2. 100853 北京 解放军总医院神经内科
- 折叠
摘要
Abstract
Objective To investigate the clinical and radiological characteristics of parakinesia brachialis oscitans (PBD) related to yawning in stroke patient and its mechanism.Methods We reported 4 patients with involuntary raising of the paralyzed limbs when yawning in neurological unit of Hainan Branch of Chinese PLA General Hospital,and analyzed their clinical characteristics together with published cases in literatures.Results In this group of stroke patients,when they yawned,their paralyzed upper limb could lift upward involuntarily.Totally 22 patients with ischemic (n=20) and hemorrhagic (n=2) stroke were enrolled.Brain imaging showed infarcts in the middle cerebral artery (MCA) in 17 patients and in the brain stem in 5 patients.This phenomenon occurred 4 hours to 4 months (14.57 ± 31.66d) after stroke onset,and lasted from 1 week to 3 years (6.70 ± 11.66 months).Corticobulbar tract and pyramidal tract were both damaged in these 22 patients.The mechanism might be that after corticobulbar tract and pyramidal tract damaged,their dominant role in the cranial nerve nuclei of the brainstem and the anterior horn cells of the spinal cord disappeared,and the projection of oxytocinergic neurons from paraventricular nucleus functions,thus causing yawning and muscle contraction.Conclusion PBO may be a rare phenomenon of abnormal movement after stroke.This phenomenon indicates damaging of pyramidal tract,and PBO disappears gradually with the recovery of pyramidal tract function.关键词
打哈欠肱肌运动倒错/脑血管病/内囊/发病机制Key words
parakinesia brachialis oscitans/cerebrovascular disease/internal capsule/pathogenesis分类
医药卫生引用本文复制引用
李剑勇,武雷,崔芳,孙柳青,熊建美..卒中后打哈欠致肱肌运动倒错的临床及影像学特点分析[J].解放军医学杂志,2018,43(3):229-233,5.
