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ID:62268932
大小:3.07 MB
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时间:2021-04-24
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1、思维导图经典案例(发烧友精华版)第十六章神经系统遗传病GeneticDiseaseoftheNervousSystemDepartmentofNeurologySecondAffiliatedHospitalHarbinMedicalUniversityGeneticdiseaseofnervoussystem1、Introduction2、FriedreichAtaxia3、SpinocerebellarAtaxia(SCA)4、Charcot-Marie-ToothDisease掌握:1、Friedreic
2、h型共济失调的主要临床特征、临床表现。2、脊髓小脑性共济失调的临床表现、诊断及鉴别诊断。熟悉:1、Friedreich型共济失调的病因、发病机制。2、脊髓小脑性共济失调的病因、发病机制。3、腓骨肌萎缩症(CMT)的临床表现、诊断及鉴别诊断。第一节GeneralIntroduction1.ConceptionGeneticdiseaseofthenervoussystem是指由于生殖细胞(germcell)或受精卵(zygote)中的遗传物质在数量、结构或功能上发生改变,使发育的个体出现以神经系统缺欠(defic
3、iency)为主要临床表现的疾病。CongenitalDiseaseFamilyDiseaseClassificationandGeneticpatternMonogenicDisordersPolygenicDisordersMitochondrialDisordersChromosomeDisorders1.Monogenicdisorders:Thebasereplacement,Insert,Deletion,repeatorabnormalexpansionofsinglegene.Autosomal
4、dominantdisordersAutosomalrecessivedisordersX-linkeddominantdisordersX-linkedrecessivedisorders动态突变性遗传CommonDiseases:Charcot-Marie-Tooth,Duchennemusculardystrophy,WilsonDisease,HereditaryAtaxia2.polygenicdisorders:areinfluencedbygenesincomplexwayswhichare
5、poorlyunderstoodbutinvolvetheinteractionofmultiplegenesandinteractionsbetweengenesandenvironmentalfactorsThecommonpolygenicdisorders:Epilepsy,migraineandarteriosclerosis.3.线粒体遗传病(mitochondrialdisorders)Mitochondrialdisordersarecausedbymutationofmitochondrion
6、(numberorstructure),Theyarematernalinheritance.opticatrophyandmitochondrialencephalomyopathy.4.ChromosomedisordersChromosomedisordersarecausedbythenumberorconstructionabnormalitiesofchromosome.forexample:Down’syndromeSymptomsandphysicalsignsClinicalfeaturesa
7、reofdiversity,includecommonandspecificsymptomsCommonsymptoms:Specificsymptoms1.Commonsymptoms:MentalretardationandDisturbanceofbehaviorLanguagedysfunction,dementiaSeizure、Nystagmus,Paraesthesia(感觉异常)Involuntarymovement(不自主运动)、AtaxiaandDystonia(肌张力障碍)Muscleat
8、rophy还可有五官畸形、脊柱裂、弓型足、指(趾)畸形、皮肤毛发异常和肝脾肿大;2.Specificsymptom:肝豆状核变性—K-F环、共济失调毛细血管扩张症—结合膜毛细血管扩张结节性硬化症—面部皮脂腺瘤神经纤维瘤—皮肤牛奶咖啡斑4.Diagnosis:(1).临床资料的搜集:尤其是发病年龄、性别、独特的症状和体征,如牛奶咖啡斑(2).系谱分析(pedigreeanalysis)可
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