帕金森症候群

帕金森症候群
Parkinsonism
帕金森症候群; Parkinsonism
病因	帕金森氏症; 路易氏体失智症; 帕金森病性失智症（英语：Parkinson's disease dementia）; 其他神经退化障碍，包括多发性系统退化症（英语：multiple system atrophy）、进行性上眼神经核麻痹症（英语：progressive supranuclear palsy）及皮质基底核退化症（英语：corticobasal degeneration）; 药物; 毒素; 代谢疾病;
分类和外部资源
医学专科	神经学
ICD-11	8A00
ICD-10	G21、G22
DiseasesDB	24212
MedlinePlus	000759
Orphanet	68402
	[编辑此条目的维基数据]

帕金森症候群（Parkinsonism）是和运动机能相关的临床症候群，其特征是颤抖、运动功能减退、僵硬（英语：Rigidity (neurology)）及平衡障碍^[1]^[2]。在帕金森氏症（PD）患者身上会有类似症状（此症候群因此而得名），而路易氏体失智症（DLB）、帕金森病性失智症（英语：Parkinson's disease dementia）（PDD）等疾病也会有此症状。这类症候群的病因范围很广，包括神经退化障碍疾病、药物、毒素、代谢疾病，或是帕金森氏症以外的神经性疾病^[3]。

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药物引起

有帕金森症候群的人当中，约有7%是因为药物的副作用而造成的，主要是因为抗精神病药，特别是吩噻嗪（例如perphenazine及氯丙嗪）、噻吨（英语：thioxanthene）（例如三氟噻吨（英语：flupenthixol）及珠氯噻醇（英语：zuclopenthixol））及丁酰苯（例如氟哌啶醇），偶尔也有因为抗忧郁药物而造成。药物引起帕金森症候群的盛行率会随年龄而上升。药物引起的帕金森症候群一但出现，多半会维持原有的程度，不像帕金森氏症会渐渐恶化^[4]。

毒素

有发现杀虫剂或除草剂暴露程度和帕金森氏症之间的关联性。若暴露在百草枯或锰乃浦（英语：Maneb）/锌锰乃浦（英语：Mancozeb）下，风险是原来的两倍^[5]。

已证实慢性锰（Mn）暴露会造成类似帕金森症候群的疾病，其特征是运动障碍，此症状无法用典型的帕金森症治疗方式（英语：Management of Parkinson's disease）来治疗，因此推测除了典型黑质内多巴胺能损失外，包括有其他的致病途径^[6]。锰会在基底核内累积，因此造成运动障碍^[7]有一种和SLC30A10基因（锰外流转运蛋白，减少细胞内锰所必需的蛋白）有关的变异和这种类似帕金森症候群疾病有关^[8]。在这疾病中看不到帕金森氏症中典型的路易体（英语：Lewy body）^[7]。

许多疾病会造成帕金森症候群。

神经退化障碍及巴金森附加症候群（英语：Parkinson plus syndrome）^[9]

皮质基底核退化症（英语：Corticobasal degeneration）^[9]
路易氏体失智症^[9]
额颞失智症（英语：Frontotemporal dementia）（匹克氏病）^[10]
格斯特曼–斯特劳斯勒–申克综合征^[9]
亨丁顿舞蹈症^[9]
Lytico-bodig症（英语：Lytico-bodig disease）（ALS complex of Guam）^[9]
多系统萎缩（英语：Multiple system atrophy）（Shy–Drager症候群）^[9]
神经吞噬作用（英语：Neuroacanthocytosis）^[9]
神经元蜡样脂褐质储积症（英语：Neuronal ceroid lipofuscinosis）^[9]
少脑桥小脑萎缩（英语：Olivopontocerebellar atrophy）^[9]
泛酸盐激活酵素关联之神经退化性疾病（英语：Pantothenate kinase-associated neurodegeneration），也称为具有脑部铁质积聚的神经变性（neurodegeneration with brain iron accumulation）^[9]
帕金突变（遗传性青少年肌张力障碍）^[9]
帕金森氏症^[9]
帕金森氏症性失智症（英语：arkinson's disease dementia）^[11]
进行性上眼神经核麻痹症（英语：Progressive supranuclear palsy）^[9]
肝豆状核变性^[9]
X连锁性肌张力障碍帕金森症（英语：X-linked dystonia parkinsonism）（Lubag症候群）^[9]

药物引发（伪帕金森症候群）

抗精神病药^[9]
锂^[9]
MDMA成瘾且经常使用^[12]^[13]
四苯那嗪（英语：Tetrabenazine）^[9]

感染

毒素

番荔枝科^[16]
一氧化碳^[9]
二硫化碳^[9]
氰化物^[9]
乙醇^[9]
己烷^[17]
锰乃浦（英语：Maneb）/锌锰乃浦（英语：Mancozeb）^[5]
锰^[9]^[6]
汞^[9]
甲醇^[9]
MPTP^[9]^[18]
百草枯^[19]^[5]
鱼藤酮^[19]
甲苯^[20]（吸入滥用（英语：inhalant abuse））^[21]

创伤

慢性创伤性脑病变^[9]

血管的

Binswanger病（英语：Binswanger's disease）（皮质下白质脑病（英语：leukoencephalopathy））^[9]
血管性痴呆（多发梗塞性）^[9]

其他

脑干受损（特别是黑质的多巴胺能核）^[22]^[23]或是基底核（特别是苍白球（英语：globus pallidus））^[24]或丘脑的受损^[25]
甲状腺机能低下症^[9]
站立性颤抖症^[26]
肿瘤伴随症候群：因为癌症产生的抗体引发的神经性症状^[27]
快速发作的肌张力障碍性帕金森病^[28]
常染色体隐性遗传性少年帕金森病^[29]

原发性震颤

根据2018年的回顾性研究，还不确定帕金森症候群和原发性震颤（英语：essential tremor）是否有关^[30]。

[1]
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[3]
Christine, Chadwick W.; Aminoff, Michael J. Clinical differentiation of parkinsonian syndromes: Prognostic and therapeutic relevance. The American Journal of Medicine. 2004-09-15, 117 (6). ISSN 0002-9343. doi:10.1016/j.amjmed.2004.03.032 （英语）.
[4]
Information Sheet: Drug-induced Parkinsonism (PDF). Parkinson’s Disease and Society. [2013-04-15]. （原始内容 (PDF)存档于2013-06-26）.
[5]
Pezzoli, Gianni; Cereda, Emanuele. Exposure to pesticides or solvents and risk of Parkinson disease. Neurology. 2013-05-28, 80 (22) [2022-10-15]. ISSN 0028-3878. PMID 23713084. doi:10.1212/WNL.0b013e318294b3c8. （原始内容存档于2023-03-03）（英语）.
[6]
Guilarte, Tomás R.; Gonzales, Kalynda K. Manganese-Induced Parkinsonism Is Not Idiopathic Parkinson’s Disease: Environmental and Genetic Evidence. Toxicological Sciences. 2015-08, 146 (2) [2022-10-15]. ISSN 1096-6080. PMC 4607750 . PMID 26220508. doi:10.1093/toxsci/kfv099. （原始内容存档于2022-12-19）（英语）.
[7]
Kwakye, Gunnar; Paoliello, Monica; Mukhopadhyay, Somshuvra; Bowman, Aaron; Aschner, Michael. Manganese-Induced Parkinsonism and Parkinson’s Disease: Shared and Distinguishable Features. International Journal of Environmental Research and Public Health. 2015-07-06, 12 (7) [2022-10-15]. ISSN 1660-4601. PMC 4515672 . PMID 26154659. doi:10.3390/ijerph120707519. （原始内容存档于2023-01-30）（英语）.
[8]
Peres, Tanara V.; Schettinger, Maria Rosa C.; Chen, Pan; Carvalho, Fabiano; Avila, Daiana S.; Bowman, Aaron B.; Aschner, Michael. “Manganese-induced neurotoxicity: a review of its behavioral consequences and neuroprotective strategies”. BMC Pharmacology and Toxicology. 2016-12, 17 (1) [2022-10-15]. ISSN 2050-6511. PMC 5097420 . PMID 27814772. doi:10.1186/s40360-016-0099-0. （原始内容存档于2023-02-02）（英语）.
[9]
Jankovic J, Lang AE. Diagnosis and Assessment. Bradley, Walter George (编). Neurology in Clinical Practice: Principles of diagnosis and management. Volume 1. Taylor & Francis. 2004: 295–96. ISBN 9789997625885.
[10]
Finger EC. Frontotemporal Dementias. Continuum (Review). April 2016, 22 (2 Dementia): 464–89. PMC 5390934 . PMID 27042904. doi:10.1212/CON.0000000000000300.
[11]
McKeith, Ian G.; Boeve, Bradley F.; Dickson, Dennis W.; Halliday, Glenda; Taylor, John-Paul; Weintraub, Daniel; Aarsland, Dag; Galvin, James; Attems, Johannes; Ballard, Clive G.; Bayston, Ashley. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology. 2017-07-04, 89 (1). ISSN 0028-3878. PMC 5496518 . PMID 28592453. doi:10.1212/WNL.0000000000004058 （英语）.
[12]
Louis, E. D.; Ottman, R. Is there a one-way street from essential tremor to Parkinson's disease? Possible biological ramifications. European Journal of Neurology. 2013-11, 20 (11) [2022-10-15]. ISSN 1468-1331. PMC 3801177 . PMID 24033795. doi:10.1111/ene.12256. （原始内容存档于2022-10-20）.
[13]
Fabrizi, Monaco, Dalla Libera. Parkinsonian syndrome following MDMA (Ecstasy) addiction. Movement Disorders. 2004, 19: S73–S74.
[14]
Maltête, David; Guyant-Maréchal, Lucie; Mihout, Bruno; Hannequin, Didier. Movement disorders and Creutzfeldt-Jakob disease: A review. Parkinsonism & Related Disorders. 2006-03-01, 12 (2). ISSN 1353-8020. PMID 16364674. doi:10.1016/j.parkreldis.2005.10.004 （英语）.
[15]
Tse W, Cersosimo MG, Gracies JM, Morgello S, Olanow CW, Koller W. Movement disorders and AIDS: a review. Parkinsonism & Related Disorders. August 2004, 10 (6): 323–34. PMID 15261874. doi:10.1016/j.parkreldis.2004.03.001.
[16]
Carod-Artal, F. J. [Neurological syndromes linked with the intake of plants and fungi containing a toxic component (I). Neurotoxic syndromes caused by the ingestion of plants, seeds and fruits]. Revista De Neurologia. 2003-05, 36 (9) [2022-10-15]. ISSN 0210-0010. PMID 12717675. （原始内容存档于2022-10-16）.
[17]
Kim EA, Kang SK. Occupational neurological disorders in Korea. Journal of Korean Medical Science (Review). December 2010, 25 (Suppl): S26–35. PMC 3023358 . PMID 21258587. doi:10.3346/jkms.2010.25.S.S26.
[18]
Watanabe Y, Himeda T, Araki T. Mechanisms of MPTP toxicity and their implications for therapy of Parkinson's disease (PDF). Medical Science Monitor. January 2005, 11 (1): RA17–23 [2019-12-08]. PMID 15614202. （原始内容存档 (PDF)于2016-03-04）.
[19]
Nandipati S, Litvan I. Environmental Exposures and Parkinson's Disease. International Journal of Environmental Research and Public Health (Review). September 2016, 13 (9): 881. PMC 5036714 . PMID 27598189. doi:10.3390/ijerph13090881.
[20]
Weiss, Janet. Chapter 151. Toluene and Xylene. Olson, Kent R. (编). Poisoning & Drug Overdose 6. New York, NY: The McGraw-Hill Companies. 2012.
[21]
Uitti RJ, Snow BJ, Shinotoh H, Vingerhoets FJ, Hayward M, Hashimoto S, Richmond J, Markey SP, Markey CJ, Calne DB. Parkinsonism induced by solvent abuse. Annals of Neurology. May 1994, 35 (5): 616–9. PMID 8179306. doi:10.1002/ana.410350516.
[22]
Jubault T, Brambati SM, Degroot C, Kullmann B, Strafella AP, Lafontaine AL, Chouinard S, Monchi O. Gendelman HE , 编. Regional brain stem atrophy in idiopathic Parkinson's disease detected by anatomical MRI. PLOS ONE. December 2009, 4 (12): e8247. Bibcode:2009PLoSO...4.8247J. PMC 2784293 . PMID 20011063. doi:10.1371/journal.pone.0008247.
[23]
Port, Dr Beckie. What brain areas are affected by Parkinson's?. Medium. 2018-06-04 [2019-03-28]. （原始内容存档于2021-07-21）.
[24]
Kuoppamäki M, Rothwell JC, Brown RG, Quinn N, Bhatia KP, Jahanshahi M. Parkinsonism following bilateral lesions of the globus pallidus: performance on a variety of motor tasks shows similarities with Parkinson's disease. Journal of Neurology, Neurosurgery, and Psychiatry. April 2005, 76 (4): 482–90. PMC 1739601 . PMID 15774432. doi:10.1136/jnnp.2003.020800.
[25]
Halliday, Glenda M. Thalamic changes in Parkinson's disease. Parkinsonism & Related Disorders. 2009-12-15, 15: S152–S155. PMID 20082979. doi:10.1016/S1353-8020(09)70804-1 （英语）.
[26]
Apartis E, Tison F, Arné P, Jedynak CP, Vidailhet M. Fast orthostatic tremor in Parkinson's disease mimicking primary orthostatic tremor. Movement Disorders. November 2001, 16 (6): 1133–6. PMID 11748748. doi:10.1002/mds.1218.
[27]
Panzer J, Dalmau J. Movement disorders in paraneoplastic and autoimmune disease. Current Opinion in Neurology. August 2011, 24 (4): 346–53. PMC 3705177 . PMID 21577108. doi:10.1097/WCO.0b013e328347b307.
[28]
Liu Y, Lu Y, Zhang X, Xie S, Wang T, Wu T, Wang C. A case of rapid-onset dystonia-parkinsonism accompanied by pyramidal tract impairment. BMC Neurology. November 2016, 16 (1): 218. PMC 5105251 . PMID 27835968. doi:10.1186/s12883-016-0743-8.
[29]
Saito M, Maruyama M, Ikeuchi K, Kondo H, Ishikawa A, Yuasa T, Tsuji S. Autosomal recessive juvenile parkinsonism. Brain & Development. September 2000,. 22 Suppl 1: S115–7. PMID 10984671.
[30]
Algarni M, Fasano A. The overlap between Essential tremor and Parkinson disease. Parkinsonism & Related Disorders. January 2018,. 46 Suppl 1: S101–S104. PMID 28729090. doi:10.1016/j.parkreldis.2017.07.006.

[Aminoff_2005-1] [1]
Aminoff MJ, Greenberg DA, Simon RP. Chapter 7: Movement disorders. Clinical Neurology 6th. Lange: McGraw-Hill Medical. 2005: 241–45. ISBN 978-0-07-142360-1.

[2] [2]
Tobottom BJ, Weiner WJ, Shulman LM. Chapter 42: Parkinsonism. Lisak RP, Truong DD, Carroll W, Bhidayasiri R (编). International Neurology: A Clinical Approach. Blackwell Publishing Ltd. 2009-09-28: 152–58. ISBN 978-1-405-15738-4.

[3] [3]
Christine, Chadwick W.; Aminoff, Michael J. Clinical differentiation of parkinsonian syndromes: Prognostic and therapeutic relevance. The American Journal of Medicine. 2004-09-15, 117 (6). ISSN 0002-9343. doi:10.1016/j.amjmed.2004.03.032 （英语）.

[4] [4]
Information Sheet: Drug-induced Parkinsonism (PDF). Parkinson’s Disease and Society. [2013-04-15]. （原始内容 (PDF)存档于2013-06-26）.

[Pezzoli2013-5] [5]
Pezzoli, Gianni; Cereda, Emanuele. Exposure to pesticides or solvents and risk of Parkinson disease. Neurology. 2013-05-28, 80 (22) [2022-10-15]. ISSN 0028-3878. PMID 23713084. doi:10.1212/WNL.0b013e318294b3c8. （原始内容存档于2023-03-03）（英语）.

[Guilarte2015-6] [6]
Guilarte, Tomás R.; Gonzales, Kalynda K. Manganese-Induced Parkinsonism Is Not Idiopathic Parkinson’s Disease: Environmental and Genetic Evidence. Toxicological Sciences. 2015-08, 146 (2) [2022-10-15]. ISSN 1096-6080. PMC 4607750 . PMID 26220508. doi:10.1093/toxsci/kfv099. （原始内容存档于2022-12-19）（英语）.

[Kwakye2015-7] [7]
Kwakye, Gunnar; Paoliello, Monica; Mukhopadhyay, Somshuvra; Bowman, Aaron; Aschner, Michael. Manganese-Induced Parkinsonism and Parkinson’s Disease: Shared and Distinguishable Features. International Journal of Environmental Research and Public Health. 2015-07-06, 12 (7) [2022-10-15]. ISSN 1660-4601. PMC 4515672 . PMID 26154659. doi:10.3390/ijerph120707519. （原始内容存档于2023-01-30）（英语）.

[Peres2016-8] [8]
Peres, Tanara V.; Schettinger, Maria Rosa C.; Chen, Pan; Carvalho, Fabiano; Avila, Daiana S.; Bowman, Aaron B.; Aschner, Michael. “Manganese-induced neurotoxicity: a review of its behavioral consequences and neuroprotective strategies”. BMC Pharmacology and Toxicology. 2016-12, 17 (1) [2022-10-15]. ISSN 2050-6511. PMC 5097420 . PMID 27814772. doi:10.1186/s40360-016-0099-0. （原始内容存档于2023-02-02）（英语）.

[Bradley2004-9] [9]
Jankovic J, Lang AE. Diagnosis and Assessment. Bradley, Walter George (编). Neurology in Clinical Practice: Principles of diagnosis and management. Volume 1. Taylor & Francis. 2004: 295–96. ISBN 9789997625885.

[Finger2016-10] [10]
Finger EC. Frontotemporal Dementias. Continuum (Review). April 2016, 22 (2 Dementia): 464–89. PMC 5390934 . PMID 27042904. doi:10.1212/CON.0000000000000300.

[McKeithConsensus2017-11] [11]
McKeith, Ian G.; Boeve, Bradley F.; Dickson, Dennis W.; Halliday, Glenda; Taylor, John-Paul; Weintraub, Daniel; Aarsland, Dag; Galvin, James; Attems, Johannes; Ballard, Clive G.; Bayston, Ashley. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology. 2017-07-04, 89 (1). ISSN 0028-3878. PMC 5496518 . PMID 28592453. doi:10.1212/WNL.0000000000004058 （英语）.

[12] [12]
Louis, E. D.; Ottman, R. Is there a one-way street from essential tremor to Parkinson's disease? Possible biological ramifications. European Journal of Neurology. 2013-11, 20 (11) [2022-10-15]. ISSN 1468-1331. PMC 3801177 . PMID 24033795. doi:10.1111/ene.12256. （原始内容存档于2022-10-20）.

[13] [13]
Fabrizi, Monaco, Dalla Libera. Parkinsonian syndrome following MDMA (Ecstasy) addiction. Movement Disorders. 2004, 19: S73–S74.

[14] [14]
Maltête, David; Guyant-Maréchal, Lucie; Mihout, Bruno; Hannequin, Didier. Movement disorders and Creutzfeldt-Jakob disease: A review. Parkinsonism & Related Disorders. 2006-03-01, 12 (2). ISSN 1353-8020. PMID 16364674. doi:10.1016/j.parkreldis.2005.10.004 （英语）.

[15] [15]
Tse W, Cersosimo MG, Gracies JM, Morgello S, Olanow CW, Koller W. Movement disorders and AIDS: a review. Parkinsonism & Related Disorders. August 2004, 10 (6): 323–34. PMID 15261874. doi:10.1016/j.parkreldis.2004.03.001.

[16] [16]
Carod-Artal, F. J. [Neurological syndromes linked with the intake of plants and fungi containing a toxic component (I). Neurotoxic syndromes caused by the ingestion of plants, seeds and fruits]. Revista De Neurologia. 2003-05, 36 (9) [2022-10-15]. ISSN 0210-0010. PMID 12717675. （原始内容存档于2022-10-16）.

[Kim2010-17] [17]
Kim EA, Kang SK. Occupational neurological disorders in Korea. Journal of Korean Medical Science (Review). December 2010, 25 (Suppl): S26–35. PMC 3023358 . PMID 21258587. doi:10.3346/jkms.2010.25.S.S26.

[Watanabe_2005-18] [18]
Watanabe Y, Himeda T, Araki T. Mechanisms of MPTP toxicity and their implications for therapy of Parkinson's disease (PDF). Medical Science Monitor. January 2005, 11 (1): RA17–23 [2019-12-08]. PMID 15614202. （原始内容存档 (PDF)于2016-03-04）.

[Nandipati-19] [19]
Nandipati S, Litvan I. Environmental Exposures and Parkinson's Disease. International Journal of Environmental Research and Public Health (Review). September 2016, 13 (9): 881. PMC 5036714 . PMID 27598189. doi:10.3390/ijerph13090881.

[20] [20]
Weiss, Janet. Chapter 151. Toluene and Xylene. Olson, Kent R. (编). Poisoning & Drug Overdose 6. New York, NY: The McGraw-Hill Companies. 2012.

[21] [21]
Uitti RJ, Snow BJ, Shinotoh H, Vingerhoets FJ, Hayward M, Hashimoto S, Richmond J, Markey SP, Markey CJ, Calne DB. Parkinsonism induced by solvent abuse. Annals of Neurology. May 1994, 35 (5): 616–9. PMID 8179306. doi:10.1002/ana.410350516.

[22] [22]
Jubault T, Brambati SM, Degroot C, Kullmann B, Strafella AP, Lafontaine AL, Chouinard S, Monchi O. Gendelman HE , 编. Regional brain stem atrophy in idiopathic Parkinson's disease detected by anatomical MRI. PLOS ONE. December 2009, 4 (12): e8247. Bibcode:2009PLoSO...4.8247J. PMC 2784293 . PMID 20011063. doi:10.1371/journal.pone.0008247.

[23] [23]
Port, Dr Beckie. What brain areas are affected by Parkinson's?. Medium. 2018-06-04 [2019-03-28]. （原始内容存档于2021-07-21）.

[24] [24]
Kuoppamäki M, Rothwell JC, Brown RG, Quinn N, Bhatia KP, Jahanshahi M. Parkinsonism following bilateral lesions of the globus pallidus: performance on a variety of motor tasks shows similarities with Parkinson's disease. Journal of Neurology, Neurosurgery, and Psychiatry. April 2005, 76 (4): 482–90. PMC 1739601 . PMID 15774432. doi:10.1136/jnnp.2003.020800.

[25] [25]
Halliday, Glenda M. Thalamic changes in Parkinson's disease. Parkinsonism & Related Disorders. 2009-12-15, 15: S152–S155. PMID 20082979. doi:10.1016/S1353-8020(09)70804-1 （英语）.

[26] [26]
Apartis E, Tison F, Arné P, Jedynak CP, Vidailhet M. Fast orthostatic tremor in Parkinson's disease mimicking primary orthostatic tremor. Movement Disorders. November 2001, 16 (6): 1133–6. PMID 11748748. doi:10.1002/mds.1218.

[27] [27]
Panzer J, Dalmau J. Movement disorders in paraneoplastic and autoimmune disease. Current Opinion in Neurology. August 2011, 24 (4): 346–53. PMC 3705177 . PMID 21577108. doi:10.1097/WCO.0b013e328347b307.

[28] [28]
Liu Y, Lu Y, Zhang X, Xie S, Wang T, Wu T, Wang C. A case of rapid-onset dystonia-parkinsonism accompanied by pyramidal tract impairment. BMC Neurology. November 2016, 16 (1): 218. PMC 5105251 . PMID 27835968. doi:10.1186/s12883-016-0743-8.

[29] [29]
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药物引起

毒素

原发性震颤

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帕金森症候群

药物引起

毒素

原发性震颤

Wikiwand in your browser!

病因

诊断

参考资料

外部链接

帕金森症候群 Parkinsonism

病因	帕金森氏症路易氏体失智症帕金森病性失智症（英语：Parkinson's disease dementia）其他神经退化障碍，包括多发性系统退化症（英语：multiple system atrophy）、进行性上眼神经核麻痹症（英语：progressive supranuclear palsy）及皮质基底核退化症（英语：corticobasal degeneration）药物毒素代谢疾病
分类和外部资源
医学专科	神经学
ICD-11	8A00
ICD-10	G21、G22
DiseasesDB	24212
MedlinePlus	000759
Orphanet	68402
[编辑此条目的维基数据]