PARKINSONISM 18
(Parkinson s disease) (Parkinsonism) 60%-85% (atypical Parkinson s diseases) (Parkinson-plus syndrome) (Secondary Parkinsonism) 2052 19
1595 77.7 250 12.2 168 8.2 12 0.6 27 1.3 / 20
("Parkinson-plus" syndromes) (atypical Parkinsonism) 1. 2. 3. 4. 5. 6. 7. ( ) 8. 9. 10. 11. 12. 21
(MSA) (PSP) 38 (Corticobasal Ganglia Degeneration Disease CBGD) 60 尾核 被殼正常巴金森症腦皮質基底核退化 腦部 F 多巴正電子斷層 (PET) 顯示巴金森症被殼受損較多, 而大腦皮質基底核退化症左側尾核受損較多 22
PET (Lewy Body Dementia/Diffuse Lewy Body Disease) 路易體 23
24
X (Normal Pressure Hydrocephalus) 25
CT MRI - CT MRI MRI MRI 掃描顯示腦瘤 26
(vascular parkinsonism) (lower body parkinsonism) CT MRI 27
28
65 MPTP 1982 / MPTP MPTP MPTP MPTP 29
1837 30
MTPT 31
1919 1926 (Essential Tremor) 48 (Huntington s Disease) 30 50 32
(20 ) (Tics) (Tourette s syndrome) 33
(Dystonia) ( ) 張 (writer s 腳指肌力不全手掌肌張力不全 34
cramp) (spasmodic torticollis) (lower limb dystonia) (blepharospasm) (oromandibular dystonia) (levodopa responsive dystonia) (levodopa responsive dystonia: ) (Wilson s Disease) 25 12-14 45 35
(caeruloplasmin) (MRI) 45 128 1.,,,1997 2. Parkinson s Disease, A Complete Guide For Patients & Families Weiner, W. J., et al, The Johns Hopkins University Press, USA, 2001 3. Cathy Chuang, Chemotherapy Induced Parkinsonism Responsive to Levodopa An under-recognized Entity, Movement Disorders 2003, Vol. 18 36
4. Movement Disorders in Clinical Practice, edited by Guy Sawle, Isis Medical Media Ltd., Oxford, U. K., 1999 5. Parkinson Disease, Parkinson-Like, Parkinson-Plus, Atypical Parkinson Disease, Parkinson Syndrome, Parkinsonism, Abraham Lieberman, National Parkinson Foundation, 2002, USA 6. Diagnosis and Management of Parkinson s Disease, 2 nd Edition, Cheryl H. Waters, Professional Communication Inc., 1999, New York, USA 7. Parkinson s Disease, Questions and Answers, 3 rd Ed., Robert Hauser, Theresa Zesiewicz, Merit Publishing International, 2000, USA 8. Jill Marjama-Lyons, Mary J. Shomon, What Your Doctor May Not Tell You about Parkinson s Disease, 2003, Warner Books, USA 9. Abraham Lieberman, 100 Questions & Answers about Parkinson Disease, Jones and Bartlett Publishers, 2003, USA. 10. : http://med.mc.ntu.edu.tw/~neuro/indexframe_educate.htm 11. Mark Stacy, Differential Diagnosis of Parkinson s Disease and the Parkinsonism Plus Syndromes, 1995 37