遅発性亜急性舞踏病

Pedro Fraiman1, Kaliny Oliveira Peixoto2, Rodrigo Alencar E Silva2

  • 1Division of General Neurology, Ataxia and Neurorheumatology Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Sao Paulo, Brazil pedro.fraiman@unifesp.br.

Practical neurology
|April 24, 2026
PubMed

71歳の女性が、当初は双極性障害と診断された遅発性の行動変化を主訴に受診し、その4年後に汎化舞踏運動と体重減少が現れた。診察の結果、前頭葉および眼球運動機能の障害を伴う過運動が認められた。脳MRスキャンでは、両側線条体にT2 FLAIR高信号域が認められた。血清および脳脊髄液において、抗collapsin response mediator protein 5/CV2抗体および抗neuronal nuclear antibody type 1/Hu抗体が陽性となり、画像診断により潜在的な胸部悪性腫瘍が特定された。患者は免疫療法に反応せず、その後まもなく死亡した。本症例は、遅発性舞踏運動の重要な原因として副腫瘍性線条体脳炎があることを強調している。精神症状は神経学的特徴に数年先行する場合があり、亜急性の進行、全身症状、および特徴的なMR画像変化などのレッドフラッグ(警告サイン)がある場合は、神経抗体および悪性腫瘍の早期調査を行うべきである。

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