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克鲁茨菲尔特-雅各布病呈现为精神疾病:病例介绍和系统审查
Brendan Huang1, Neeva Shafiian1,2, Paul Joseph Masi3
1Department of Neurology, Northwell, New Hyde Park, NY, United States.
Frontiers in neurology
|September 13, 2024
概括
克鲁茨菲尔特-雅各布病 (CJD) 可以模仿精神疾病,延迟诊断. 迅速使用EEG,MRI和脑脊液测试对于准确和及时的CJD诊断至关重要.
科学领域:
- 神经学 神经学
- 神经科学是一个神经科学.
- 子疾病是子疾病.
背景情况:
- 克鲁茨菲尔特-雅各布病 (CJD) 是一种致命的神经退行性病.
- 由于CJD的多种表现,往往导致误诊为精神疾病.
- 早期诊断具有挑战性,但对于患者管理至关重要.
研究的目的:
- 报告一个模仿精神疾病的CJD病例.
- 为了审查CJD的诊断工作,呈现为精神病学模仿.
- 突出神经成像和脑脊液生物标志物的实用性.
主要方法:
- 一个54岁的男性患有CJD,呈现精神症状的病例报告.
- 对临床病史,神经学检查和连续大脑MRI发现的审查.
- 大脑脊髓液分析 (14-3-3,RT-QuIC),EEG,以及尸检确认.
- 在PubMed上对最初被诊断为精神疾病的CJD病例进行文献搜索.
主要成果:
- 患者表现出行为变化,认知障碍和步态不稳定.
- 最初的大脑MRI显示扩散受限;重复MRI证实进展.
- 脊髓14-3-3和RT-QuIC呈阳性;尸检证实了CJD.
- 文献审查表明,CJD误诊为精神疾病的比例很高.
结论:
- 结核病可以出现精神症状,构成诊断挑战.
- 迅速利用EEG,MRI和CSF研究有助于正确的CJD诊断.
- 在复杂的病例中,可能需要连续MRI和考虑脑活检.
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