Primary lateral sclerosis
Introduction
Introduction to primary lateral sclerosis Primary lateral sclerosis (PLS) is a motor neuron disease characterized by corticospinal tract involvement, with sputum paraplegia and normal sensation. The disease belongs to the category of TCM syndromes, which is caused by wind, phlegm blockage of tendons, liver and kidney deficiency, and fascia dystrophy. More common in men aged 31 to 60 years; insidious onset, slow progress. Very rare, selective damage to the corticospinal tract, leading to functional deficits in motor neurons on the limbs. Selective damage to the corticospins leads to functional deficits in motor neurons on the limbs. A motor neuron disease characterized by corticospinal tract involvement, which is characterized by paralysis and paraplegia. The disease belongs to the category of TCM syndromes, which is caused by wind, phlegm blockage of tendons, liver and kidney deficiency, and fascia dystrophy. More common in men aged 31 to 60 years; insidious onset, slow progress. basic knowledge The proportion of sickness: 0.0001% - 0.0002% Susceptible people: more common in men aged 31 to 60 Mode of infection: non-infectious complication:
Cause
Primary lateral sclerosis
Selective damage to the corticospins leads to functional deficits in motor neurons on the limbs. A motor neuron disease characterized by corticospinal tract involvement, which is characterized by paralysis and paraplegia. The disease belongs to the category of TCM syndromes, which is caused by wind, phlegm blockage of tendons, liver and kidney deficiency, and fascia dystrophy. More common in men aged 31 to 60 years; insidious onset, slow progress.
Prevention
Primary lateral sclerosis prevention
The focus is on patient care, and systematic holistic care is an important factor in ensuring treatment success.
Complication
Primary lateral sclerosis complications Complication
If pseudo-ball paralysis occurs, symptoms such as difficulty swallowing, difficulty in pronunciation, etc. may occur.
Symptom
Symptoms of primary lateral sclerosis Common symptoms Lower extremity or soft body of the lower extremities Muscle tension enhances lower extremity muscle spasm
symptom
(1) spastic paraplegia: the symmetry of the lower limbs is weak and stiff, and it is a gait when walking, gradually involving both upper limbs. Generally, the muscle tension is increased, the tendon reflex is hyperthyroidism, the lower limbs are more obvious, and the pathological reflex is positive. In the late stage, there may be urinary incontinence.
(2) No muscle atrophy and fasciculation.
(3) The objective feeling is normal, and the unconscious intelligent changes.
Incidence characteristics
(1) middle-aged or later onset; the first symptom is symmetrical spasm of both lower limbs, slow progression, progressive and double upper limbs, increased limb muscle tone, hyperreflexia and pathology, no muscle atrophy, no bundle Trembling, feeling normal;
(2) pseudobulbar paralysis occurs in the cortical medullary bundle degeneration, accompanied by emotional instability, strong crying and strong laughter;
(3) Most of them are slow progressive disease, and occasionally long-term survival reports.
Examine
Primary lateral sclerosis examination
1. Neuroelectrophysiology: Electromyography is a typical neurogenic change. At rest, the fibrillation potential and positive sharpness can be seen, and sometimes the tremor potential can be seen. When the small force contracts, the motor unit potential time is widened, the amplitude is increased, and the multiphase wave is increased. The vigorous contraction presents a simple phase. The nerve conduction velocity is normal. Motor evoked potentials help to determine upper motor neuron damage.
2, muscle biopsy: helpful for diagnosis, but no specificity, early neurogenic muscle atrophy, late in the light microscopy and myogenic muscle atrophy is not easy to identify.
3, other: blood biochemistry, CSF examination, no abnormalities, creatine phosphokinase (CK) activity can be mildly abnormal, MRI can show that some cases of spinal cord and brain stem atrophy become smaller.
Diagnosis
Diagnosis and differentiation of primary lateral sclerosis
diagnosis
1. Neuroelectrophysiology: Electromyography is a typical neurogenic change. At rest, the fibrillation potential and positive sharpness can be seen, and sometimes the tremor potential can be seen. When the small force contracts, the motor unit potential time is widened, the amplitude is increased, and the multiphase wave is increased. The vigorous contraction presents a simple phase. The nerve conduction velocity is normal. Motor evoked potentials help to determine upper motor neuron damage.
2, muscle biopsy: helpful for diagnosis, but no specificity, early neurogenic muscle atrophy, late in the light microscopy and myogenic muscle atrophy is not easy to identify.
3, other: blood biochemistry, CSF examination, no abnormalities, creatine phosphokinase (CK) activity can be mildly abnormal, MRI can show that some cases of spinal cord and brain stem atrophy become smaller.
Differential diagnosis
1. Syringomyelia: with segmental sensory separation, spinal air angiography showed symmetry expansion of the spinal cord.
2. Spinal cord tumors: often have root pain or conduction beam dysfunction, often asymmetrical, cerebrospinal fluid examination protein content increased, myelography and MRI help identify.
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