慢性腹腔内血瘤模仿额外皮拉米德症状
Po Wen Cheng1, Ruei An Tsai1, Chien-Hui Lee2
1General Psychiatry Department, Yuli Hospital, Ministry of Health and Welfare, Hualien, Taiwan.
BMJ case reports
|December 5, 2023
概括
一名慢性精神分裂症患者出现了步态障碍,最初被误认为是药物. 脑部CT显示慢性下皮质血瘤,成功通过手术治疗,解决了步行问题.
科学领域:
- 神经学 神经学
- 老年病的医生 老年病的医生
- 精神病学是一个精神病学.
背景情况:
- 步态障碍是老年患者的一个常见症状.
- 抗精神病药物可以引起影响步态的额外金字塔症状.
- 慢性腹膜下血腫可以呈現微妙的神經缺陷.
研究的目的:
- 报告一个精神分裂症患者的步态障碍病例.
- 突出诊断挑战,将药物副作用与其他神经病因区分开来.
- 强调在无法解释的步态障碍中考虑焦点脑损伤的重要性.
主要方法:
- 一个70多岁的男性患者的病例报告,患有慢性精神分裂症.
- 最初的治疗包括逐渐减少抗精神病药物.
- 诊断工作包括临床观察和脑CT扫描.
- 已确定的慢性腹腔内血瘤的手术干预.
主要成果:
- 尽管调整了药物,但步行障碍仍然存在.
- 临床观察显示左侧逐渐占主导地位和整体软弱.
- 大脑CT证实了慢性腹腔内血瘤.
- 紧急手术导致患者康复和出院.
结论:
- 精神分裂症患者的步行障碍可能是由潜在的神经疾病引起的,而不仅仅是药物的副作用.
- 慢性腹腔内血瘤应考虑在无法解释的步态障碍的差异诊断中,即使没有创伤史.
- 迅速的外科手术干预下皮质血瘤可以导致显著的神经恢复.
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