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[脑血管疾病后的类克吕弗-布西综合征及额叶症状]

[Klüver-Bucy-like syndrome and frontal symptoms following cerebrovascular disease].

作者信息

Ozdemir Hatice, Rezaki Murat

机构信息

Uzm. Psk., Hacettepe U Tip Fak., Oğrenci Sağlik Merkezi, Ankara.

出版信息

Turk Psikiyatri Derg. 2007 Summer;18(2):184-8.

Abstract

We present a case with frontal lobe symptoms and Klüver-Bucy-like syndrome following subarachnoid hemorrhage and hydrocephaly. Klüver-Bucy syndrome is a rare neurobehavioral condition characterized by placidity, visual agnosia, hypersexuality, hyperorality, and hypermetamorphosis (the tendency to react to or to touch every visual stimulus). The syndrome is usually associated with lesions of the amygdala or its pathways, and it occurs after head trauma, anoxia-ischemic encephalopathy, herpes simplex encephalitis, and Reye 's syndrome. A 45-year-old right-handed female patient, who developed hydrocephaly after meningitis due to bilateral middle cerebral artery aneurysm surgery presented to our psychiatry clinic with various behavioral and emotional changes. In her psychiatric examination, increased and disinhibited speech, perseveration, placidity, impaired go/no go task performance, and hyperphagia were observed. The patient was treated with risperidone 0.5 mg/day. Magnetic resonance imaging (MRI) of the brain showed encephalomalacic-gliotic changes in the anterior superior medial temporal lobe (including bilateral amygdala), hydrocephalus, bilateral abnormal signal intensity in the white matter of the frontal region, and bilateral infarction in the centrum semiovale. Symptoms, such as placidity (loss of anger and fear) and altered dietary habits are some of the clinical features of Klüver-Bucy syndrome, whereas disinhibition and perseveration are associated with prefrontal cortex dysfunction.

摘要

我们报告一例蛛网膜下腔出血和脑积水后出现额叶症状及类克-布综合征的病例。克-布综合征是一种罕见的神经行为疾病,其特征为平静、视觉失认、性欲亢进、口欲亢进和视觉刺激反应过度(对每个视觉刺激做出反应或触摸的倾向)。该综合征通常与杏仁核或其传导通路的病变有关,发生于头部外伤、缺氧缺血性脑病、单纯疱疹性脑炎和瑞氏综合征之后。一名45岁右利手女性患者,因双侧大脑中动脉动脉瘤手术并发脑膜炎后出现脑积水,因各种行为和情绪变化前来我们的精神科门诊就诊。在其精神检查中,发现言语增多且不受抑制、持续言语、平静、执行停止-继续任务表现受损及食欲亢进。患者接受了每天0.5毫克利培酮的治疗。脑部磁共振成像(MRI)显示颞叶前上内侧(包括双侧杏仁核)有脑软化-胶质增生改变、脑积水、额叶白质双侧异常信号强度以及半卵圆中心双侧梗死。诸如平静(愤怒和恐惧丧失)和饮食习惯改变等症状是克-布综合征的一些临床特征,而行为抑制解除和持续言语与前额叶皮质功能障碍有关。

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