儿童肌无力的病因和评估
- Author
- Russell Migita, MD
Russell Migita, MD
- Clinical Associate Professor of Pediatrics
- University of Washington Medical School
- Section Editor
- George A Woodward, MD
George A Woodward, MD
- Section Editor — Pediatric Signs and Symptoms
- Professor of Pediatrics
- University of Washington School of Medicine
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
- Translators
- 陈幼芬, 副主任医师
陈幼芬, 副主任医师
- 厦门大学附属第一医院儿科
引言
本文将总结儿童肌无力的评估。婴儿或新生儿肌张力减退或肌无力的评估将单独讨论。 (参见“肌张力减退和肌无力婴儿的概述”和“致新生儿肌张力低下外周神经肌肉疾病概述”)
定义
肌无力是指肌肉自主主动活动对抗阻力的能力下降。肌无力可能起源于运动单元的任何部分，通常分为上运动神经元肌无力和下运动神经元肌无力，具体如下：
●上运动神经元肌无力–上运动神经元肌无力源于大脑皮质和下行至背侧脊髓前角细胞(但不包括前角细胞)的皮质脊髓束的病变。
●下运动神经元肌无力—下运动神经元肌无力源于前角细胞、周围神经、神经肌肉接头或肌肉的病变。
肌无力可能与肌张力减退或共济失调相混淆。肌张力减退是指对被动活动的阻力下降。共济失调指肌肉的协调能力下降。 (参见“肌张力减退和肌无力婴儿的概述”和“对急性共济失调儿童的认识”)
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To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:Literature review current through: 2017-06 . | This topic last updated: 2015-11-18.The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.References- Sweney MT, Silver K, Gerard-Blanluet M, et al. Alternating hemiplegia of childhood: early characteristics and evolution of a neurodevelopmental syndrome. Pediatrics 2009; 123:e534.
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TopTopic Outline
- 引言
- 定义
- 急性肌无力的原因
- 上运动神经元病变
- - 大脑皮质
- 颅内出血
- 脑卒中
- 脑肿瘤
- 癫痫发作
- 偏瘫型偏头痛
- 儿童期交替性偏瘫
- - 脊髓
- 脊髓创伤
- 脊髓肿瘤
- 脊柱旁感染或炎症
- 横贯性脊髓炎
- 下运动神经元病变
- - 前角细胞疾病
- 脊髓灰质炎和其他肠道病毒
- - 周围神经
- 吉兰-巴雷综合征
- 周围神经毒素
- 急性间歇性卟啉病
- 其他
- - 神经肌肉接头疾病
- 肉毒中毒
- 重症肌无力
- 有机磷或氨基甲酸酯类中毒
- 神经毒性蛇毒液螫入
- 蜱瘫痪
- - 肌肉
- 横纹肌溶解
- 肌炎
- 家族性周期性瘫痪
- 旋毛虫病
- - 其他
- 电解质紊乱
- 药物相关性
- 转换障碍
- 慢性肌无力的病因
- 评估
- 初始稳定
- 病史
- 体格检查
- - 肌肉检查
- - 神经系统检查
- - 其他发现
- 辅助检查
- 诊断方法
- 突然起病的严重肌无力
- 急性起病的肌无力
- 亚急性或慢性肌无力
- 总结
- REFERENCES