- 期刊
Cheiro - Oral Syndrome: Identifcation of the Lesion Sites and a Proposal for Its Clinical Classification
手－口症候群：臨床分類與病灶鑑別
摘要
研究五位以同側口角和手有麻木感覺症狀的手口症候群病人。分別接受電腦斷層攝影來決定病灶的位置，必要時並做磁振掃瞄攝影進一步確定。結果五位病人中有三位是丘腦的梗塞，一位是橋出血和一位是右額頂葉的腫瘤。這些口－手症候群病人生理病理特性可根據相對應的解部位置如丘腦；橋腦和頂葉，來加以闡明。五病例中，三位有典型的表現，其餘兩位非典型病例則伴隨有暫時性之半側徵候。基本上除了上述三位典型病例，再加上從國外文獻上的13位已經確定是手－口症候群的病人而整理出一個臨床分類。這個分類是基於病人的發病年齡、性別、病灶位置、病理分類、危險因素和其他臨床特徵而得來的。從這16個病例所獲得的分類中可區分成三組。(1)丘腦病灶多是因梗塞引起，而且常伴有半側神經性徵候。(2)頂葉病灶全都發現是腫瘤。(3)而橋腦卻以出血表現者眾。其次兩個顯著的特微分別是發病年齡歲數較大而且女性比例較高。綜觀上述的分類可以將手－口症候群更有系統地加以界定和解釋。
關鍵字
無資料並列摘要
Five cases suffering from unilateral paresthesia over the corner of the mouth and the hand on the same side were examination for cheiro-oral syndrome. Of these, three cases were typical and the other were variant cases associate with transient hemi-signs. Lesion sites were identified by computed tomographic (CT) scan, magnetic resonance imaging (MRI) or both. Of the five patients, lesions were due to thalamic infarction in three cases, pontine hemorrhage in one case, and tumor compression on the right frontoparietal lobe in the last case. The pathophysiology of all cases were classified according to location of the lesion on the thalamus, the pons, and the parietal lobe, which are the usual anatomical sites responsible for this syndrome. Based on the three typical cases and thirteen cases cited from the English literature, a clinical classification has been established. The classification is based on age at the time of onset, gender, lesion site, etiology, risk factors, and certain clinical features. These sixteen cases fell into three distinct groups: a) those in which the thalamic lesions were related to infarction, b) those in which tumors, or in rare cases infarction, were found in the parietal lobe, and c)those in which hemorrhage occurred in the pons. Using this classification, the cheiro-oral syndrome can be more systematically defined.