在肺癌治疗和血液透析期间出现主动幻觉的维尼克脑病:一个病例报告
Marino Hirata1, Mayumi Ishida2, Hideki Onishi2
1Department of Supportive Medicine, Saitama Medical University International Medical Center, Saitama, Japan.
Palliative & supportive care
|January 14, 2025
概括
维尼克脑病 (Wernicke encephalopathy,简称WE) 是一种胺缺乏障碍,可引起幻觉,特别是在患有癌症且接受血液透析的非酒精成年人中. 及时治疗胺可以解决这些症状.
科学领域:
- 神经科学是一个神经科学.
- 在瘤学瘤学.
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 韦尼克脑病 (Wernicke encephalopathy,简称WE) 是一种神经精神病学的紧急情况,是由于胺缺乏引起的.
- 经典的WE症状包括混乱,缺氧和眼,但幻觉不那么常见.
- 危险因素包括酒,恶性瘤和慢性病,特别是血液透析.
研究的目的:
- 报告一个为肺癌进行血液透析的非酒精患者的沃尼克脑病变病例,呈现出活性幻觉.
- 强调在患有风险因素的患者中考虑WE的重要性,即使有非典型症状.
主要方法:
- 一份病例报告,一名81岁的肺癌妇女接受血液透析,出现了急性幻觉.
- 基于对WE的临床怀疑,进行了静脉注射的胺.
- 测量了全血胺度,发现是边界的.
主要成果:
- 患者突然出现了积极的视觉幻觉和妄想.
- 在静脉注射胺剂后,幻觉和妄想迅速改善.
- 患者的全血胺度处于边界 (24 ng/ml).
结论:
- 在对幻觉的差异诊断中,即使在患有恶性瘤和血液透析等危险因素的非酒精患者中,也应考虑沃尼克脑病变.
- 胺替代疗法可以有效地解决与WE相关的幻觉.
- 早期识别和治疗WE至关重要,特别是在风险人群中.
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