Otoimmün nörolojik hastalıkların neden olduğu hareket bozukluklar
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Date
2011-01-19
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Uludağ Üniversitesi
Abstract
Otoimmün hastalıklar, farklı dokulara karşı humoral immün cevap aracılığıyla gelişen kronik heterojen bir hastalık grubudur. Hareket bozuklukları, bir çok nörolojik hastalığın bulgusu olarak karşımıza çıkabilir. Bu yazıda, farklı nöroimmünolojik hastalıklarda görülen hareket bozuklukları ve tedavi yaklaşımları tartışılacaktır. Poststreptokokkal enfeksiyonlarla ilişkili hareket bozuklukları, başlıca korenin görüldüğü Sydenham koresi, myoklonus ya da distoninin görüldüğü poststreptokokkal akut dissemine ensefalomyelit (ADEM) ya da Streptokok enfeksiyonu ile ilişkili pediatrik otoimmün nöropsikiyatrik hastalık (PANDAS)’tır. Hareket bozukluklarının görüldüğü konnektif doku hastalıkları, Sistemik lupus eritematosus (SLE), Primer antifosfolipid antikor sendromu (PAPS), Poliarteritis nodosa (PAN), Behçet hastalığı ve Hashimato tiroiditidir. Bu hastalıklarda da genellikle, koreiform hareket bozuklukları tanımlanmaktadır. Paraneoplastik sendromlarda, kanserin uzak etkisi olarak, immunolojik zeminde ortaya çıkan farklı hareket bozuklukları görülebilir. Demiyelinizan hastalıklar arasında Multipl skleroz’da tanımlanan en sık hareket bozukluğu tremordur. Sonuç olarak, farklı grup otoimmün hastalıklarda ortaya çıkan hareket bozukluklarının fenomenolojik olarak tanımlanması ve tanıya göre tedavi başlanması büyük önem taşımaktadır.
Autoimmune diseases are a group of diseases which are chronic and heterogeneous and develop by humoural immune response to different tissues. Movement disorders may appear as a sign of many neurological diseases. In this review, movement disorders in different neuroimmunological diseases and their treatment modalities will be discussed. Movement disorders that are related to poststreptococcal infections are Sydenham chorea mainly demonstrating chorea, poststreptococcal acute disseminated encephalomyelitis that include myoclonus or distonia, and pediatric autoimmune neuropsychiatric disease that is related to streptococcal infection (PANDAS). Connective tissue diseases those include movement disorders are mainly Systemic Lupus Erythamotosis (SLE), Primary antiphospholipid antikor syndrome (PAPS), Polyartheritis nodosa (PAN), Behçet’s disease and Hashimoto's thyroiditis. In these diseases, choreiform movement disorders are also usually described. In paraneoplastic syndromes, different movement disorders that develop in an immunological base may be seen as a distant effect of the cancer. In multiple sclerosis (MS), which is the most frequent demyelinizing disease , the most frequent movement disorder that is described is tremor. Consequently, it is very important that movement disorders that are seen in different autoimmune diseases should be described phenomenologically and be treated accordingly.
Autoimmune diseases are a group of diseases which are chronic and heterogeneous and develop by humoural immune response to different tissues. Movement disorders may appear as a sign of many neurological diseases. In this review, movement disorders in different neuroimmunological diseases and their treatment modalities will be discussed. Movement disorders that are related to poststreptococcal infections are Sydenham chorea mainly demonstrating chorea, poststreptococcal acute disseminated encephalomyelitis that include myoclonus or distonia, and pediatric autoimmune neuropsychiatric disease that is related to streptococcal infection (PANDAS). Connective tissue diseases those include movement disorders are mainly Systemic Lupus Erythamotosis (SLE), Primary antiphospholipid antikor syndrome (PAPS), Polyartheritis nodosa (PAN), Behçet’s disease and Hashimoto's thyroiditis. In these diseases, choreiform movement disorders are also usually described. In paraneoplastic syndromes, different movement disorders that develop in an immunological base may be seen as a distant effect of the cancer. In multiple sclerosis (MS), which is the most frequent demyelinizing disease , the most frequent movement disorder that is described is tremor. Consequently, it is very important that movement disorders that are seen in different autoimmune diseases should be described phenomenologically and be treated accordingly.
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Keywords
Otoimmün hastalıklar, Autoimmune diseases, Hareket bozuklukları, Movement disorders, Chorea, Tremor, Kore, Tremor
Citation
Özbek, S. E. (2010). "Otoimmün nörolojik hastalıkların neden olduğu hareket bozukluklar" Uludağ Üniversitesi Tıp Fakültesi Dergisi, 36(3),127-133.