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原发性震颤多累及头颈及上肢,而影响喉部出现声音震颤(VT)者甚少见,文献曾有纪录,然日本尚无报导。作者介绍1例男性,59岁播音员,声音和手震颤加重4年,VT多见于讲话、唱歌与随意持续发音时,而打鼾、哈欠及笑时则无。同胞中2/6人手震颤,但无VT。体查见显著VT和有规律的声音停顿,伴颈、咽软腭和腹肌同步规律收缩,患者难以作流畅连续发音,上肢有姿势性和意向性震颤。甲状腺功能、EEG及头颅CT均正常。咽喉纤维镜见随意持续发音时声带运动正常,在VT时喉部有垂直方向震颤,声带虽观察困难,但至少无声带震颤和周期性声门关闭运动。电生理学见:(1)随意发持续性“啊”音时,声带肌无周期性的群化放电,而环甲肌有5H_z之周期性群化放电,音图亦见同样的5H_z
Primary tremor affects the head and neck more than the upper extremities, and seizures affecting the vocal throat (VT) are rarely seen in the throat. Records have been published in the literature but no reports have been reported in Japan. The authors describe a male, 59-year-old announcer, with aggravating noise and hand tremor for 4 years. VT is more common when speaking, singing and talking freely, while snoring, yawning and laughing. Twenty-six people in our country have tremor, but no VT. Physical examination found significant VT and regular voice pause, with the neck, pharyngeal soft palate and abdominal muscles regularly contracted, patients with smooth continuous articulation difficult, upper extremity posture and intention tremor. Thyroid function, EEG and head CT are normal. Vocal cord throat fiber mirror see the sound continued to move properly at VT when the throat vertical tremor, although the observation of vocal cord difficulties, but at least no vocal tremor and periodic glottis closing movement. Electrophysiology, see: (1) random hair continuous “ah” sound, the vocal cord muscle group cyclical discharge, and cyclical muscular 5H_z periodic group discharge, the tone chart also see the same 5H_z