迟发性亚急性舞蹈症

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

一名71岁女性患者出现晚发性行为改变,最初被诊断为双相情感障碍,4年后继发全身性舞蹈样动作及体重下降。体格检查显示过度运动症状,并伴有额叶征象和眼动异常。脑部MRI显示双侧纹状体T2 FLAIR高信号。血清和脑脊液抗塌陷反应调节蛋白5/CV2抗体及抗神经元核抗体1型/Hu抗体均为阳性,影像学检查发现潜在的胸腔恶性肿瘤。患者对免疫治疗无反应,不久后死亡。本病例凸显了副肿瘤性纹状体脑炎是导致晚发性舞蹈症的重要病因。精神症状可先于神经系统表现数年出现,亚急性进展、全身症状及特征性MRI改变等警示征象应促使临床及早开展神经元抗体和恶性肿瘤的相关检查。 副肿瘤性纹状体脑炎,晚发性舞蹈症,抗CV2抗体,抗Hu抗体,MRI,行为改变,体重下降,眼动异常,额叶征象,免疫治疗无效,胸腔恶性肿瘤

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