Chronic post-hypoxic myoclonus, also known as Lance-Adams syndrome (LAS), is a rare complication of successful cardiopulmanry resuscitation often accompanied by action myoclonus and cerebellar ataxia. It is seen in patients who have un-dergone a cardiorespiratory arrest, regained consciousness afterwards, and then developed myoclonus days or weeks after the event. Worldwide, 122 cases have been reported in the literature so far, including 1 case of Chinese. Here we report 2 Chinese LAS patients with detailed neuroimagings. Cranial single photon emission computed tomography (SPECT) of patient 1, a 52-year-old woman, showed a mild hypoperfusion in her left temporal lobe, whereas patient 2, a 54-year-old woman, manifested a mild bilateral decrease of glucose metabolism in the frontal lobes and a mild to moderate decrease of the N-acetyl aspartate (NAA) peak in the bilateral hippocampi by cranial [18F]-fluorodeoxyglucose positron emission tomographic (PET) scan and cranial magnetic resonance spectroscopy (MRS), respectively. We also review the literature on the neuroimaging, pathogenesis, and treatment of LAS.
ZHANG Yan-xing1,2, LIU Jian-ren1, JIANG biao3, LIU Hui-qin1, DING Mei-ping1, SONG Shui-jiang1, ZHANG Bao-rong1, ZHANG Hong4, XU Bin5, CHEN Huai-hong6, WANG Zhong-jin1, HUANG Jian-zheng1 (1Department of Neurology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China) (2Department of Neurology, Shaoxing People’s Hospital, Shaoxing 312000, China) (3Department of Radiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China) (4Department of Nuclear Medicine, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China) (5Department of Neurology, the Second Affiliated Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou 310005, China) (6Department of Geratology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China)
目的：探讨用球囊扩张和支架植入术（Carotid angioplasty and stenting，CAS）治疗高危颈动脉狭窄患者的疗效和并发症。方法：从2003年3月到2006年4月对8例高危的颈动脉狭窄患者进行CAS治疗，观察CAS的疗效和并发症。结果：对8例症状性颈动脉狭窄患者的9根颈动脉进行了CAS治疗。CAS术后9根颈动脉的平均狭窄率从75．49／5显著减少到28．89／5（P〈0．001，配对t检验）。所有的患者都使用了脑保护装置。全部使用自膨式支架，其中大部分是Precise镍钛合金支架（77．8％）。术中5例患者发生了一过性心率减慢和血压下降。经过21．5±14．2（4～41）月的随访，所有患者没有再发卒中，除1例患者仍有轻度头晕外，其余患者头晕、眩晕症状全部消失。6例（75％）患者通过颈动脉超声和／或CTA随访发现支架通畅，无再狭窄。结论：采用脑保护装置的CAS是治疗高危颈动脉狭窄的安全可行的方法，但其疗效和安全性需要作进一步观察。
