脊髓小脑性共济失调14型1例病例汇报OA
A Case Report of Spinocerebellar Ataxia Type 14
目的:报告 1 例以四肢不自主运动及右侧肢体无力为主要表现的脊髓小脑共济失调 14 型(spinocerebellar ataxia type 14,SCA14)病例,结合临床特征、基因检测及文献复习,探讨其诊断与鉴别要点.方法:对河北北方学院附属第一医院收治的 1 例 63 岁女性患者进行临床评估,包括病史采集、神经系统查体、脑脊液分析、影像学检查及基因测序,并回顾相关文献.结果:该患者家族有 2 人已经出现肢体不自主运动症状,表现为进行性四肢震颤,家族史提示常染色体显性遗传模式.基因检测发现PRKCG基因错义突变(c.1234G>A,p.Gly412Arg),确诊为SCA14.经对症治疗及康复干预,症状有所改善.结论:SCA14 临床异质性强,以震颤、肌张力障碍和共济失调为特征,基因检测是确诊关键.早期识别及干预可延缓功能衰退,遗传咨询对家族成员风险评估至关重要.
Objective:To report one case of spinocerebellar ataxia type 14(SCA14)mainly presenting with involuntary limb movements and right limb weakness,and to explore the key points of diagnosis and differential diagnosis combined with clinical features,genetic testing and literature review.Methods:Clinical evaluation was performed in a 63-year-old female patient,including medical history collection,neurological examination,cerebrospinal fluid analysis,imaging examination and genetic sequencing,with relevant literature reviewed.Results:Two family members of the patient had presented involuntary limb movements manifested as progressive limb tremor.The family history suggested an autosomal dominant inheritance pattern.Genetic testing identified a missense mutation of the PRKCG gene(c.1234G>A,p.Gly412Arg),and the patient was finally diagnosed with SCA14.Symptomatic treatment and rehabilitation intervention achieved partial improvement of clinical symptoms.Conclusion:SCA14 shows strong clinical heterogeneity,characterized by tremor,dystonia and ataxia.Genetic testing is the key to definite diagnosis.Early recognition and intervention can delay functional decline,and genetic counseling is essential for risk assessment of family members.
张雷;王天珉;薛茜
河北北方学院研究生学院,张家口,075000,中国河北北方学院研究生学院,张家口,075000,中国河北北方学院附属第一医院神经内科,张家口,075000,中国
医药卫生
脊髓小脑共济失调临床表现早期诊断
spinocerebellar ataxiaclinical manifestationearly diagnosis
《神经药理学报》 2026 (2)
41-44,4
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