頁籤選單縮合
| 題 名 | 家族遺傳性顫抖與陷窩梗塞伴隨老年失智之病例報告=A Patient with Familial Tremor, Lacuuar Infarction and Dementia |
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| 作 者 | 潘冠碩; 莊麗玲; 胡名霞; | 書刊名 | 中華民國物理治療學會雜誌 |
| 卷 期 | 24:3 1999.05[民88.05] |
| 頁 次 | 頁46-59 |
| 分類號 | 418.996 |
| 關鍵詞 | 顫抖; 腦中風; 失智症; 跌倒; Tremor; Cerebrovascular accidents; Dementia; Fall; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 顫抖常造成老年人日常生活功能上之不便，近兩世紀以來，醫學界發現顫抖常發 生在家族親人身上， 稱為家族遺傳性顫抖（ familial tremor ）， 是原發性顫抖 （ essential tremor ）的一類，為正染色體顯性遺傳。 陷窩梗塞（ lacunar infarction ）則為長期的高血壓後常見的腦血管病理變化，是腦中風的一種，根據發生部位的不同而有 相異的臨床徵狀。老年失智症的發生率隨年齡的增長而增加，最為常見的有阿爾茲海默症以 及血管性因素所引起的失智症。家族遺傳性顫抖、陷窩梗塞與老年失智並不一定伴隨發生， 然而一旦共同發生，會造成病人的生活能力變差，包括平衡能力的降低而時常跌倒。本文藉 由對一位 72 歲的兼具家族遺傳性顫抖及少許陷窩梗塞和輕微老年失智症患者之病例介紹， 報告關於這三類疾病之病理機轉、臨床類型、診斷方法及治療原則。由於病人照會物理治療 之主要原因是多次跌倒與平衡不良，因此亦以電腦平衡測定儀來評估其平衡能力。希望藉此 增加對三種疾病的瞭解，以及藉由比較病例在治療前後進步的情形，討論物理治療對此三種 疾病之因應原則與方法。 |
| 英文摘要 | Tremor may severely hinder the activities of daily living in the elderly. In recent centuries, it is noted that tremor may occur in members of a family, hence the name familial tremor. The familial tremor is autosomal dominant and is a type of essential tremor. The prevalence has been reported to be between 17% to 70%. Lacunar infarction is occlusion of penetrating arteries 100 to 400 μ m in diameter, representing 10% to 30% of all strokes. The incidence of dementia increases with age and may occur after multiple vascular trauma in the brain. Reported patient is a 72 years old male retired from a financial company, lie was diagnosed to have hypertension and lacunar infarction in February 1994 after a fainting incidence. Acute dementia attack occurred in August of 1994. His self care ability gradually deteriorated thereafter. In July 1998, the patient complained of frequent falls, severe hand tremor, and general weakness. He was adrrfitted to the National Taiwan University Hospital for a complete check-up, physical therapy was consulted on August 7. Physical therapy evaluation and treatment was provided with significant improvement in balance, hand dexterity and muscle strength. The Smart Balance Master system evaluation revealed deviation to the left during quiet stance and unsteadiness under varied sensory conditions. Slight elongation in the medium latency muscle response was noted in tibialis anterior muscle from electromyographic examination. The nature of this complex phenomenon is reviewed and the implications for physical therapy discussed. |
本系統中英文摘要資訊取自各篇刊載內容。