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[临床表现及磁共振成像表现酷似变异型克雅氏病的格斯特曼-施特劳斯勒-谢inker综合征(GSS-P102L)病例]

[Case of Gerstmann-Sträussler-Scheinker syndrome (GSS-P102L) mimicking variant Creurtzfeldt-Jakob disease in clinical manifestation and MRI findings].

作者信息

Kanata Akiko, Saigoh Kazumasa, Mitsui Yoshiyuki, Kitamoto Tetsuyuki, Kusunoki Susumu

机构信息

Department of Neurology, Kinki University School of Medicine.

出版信息

Rinsho Shinkeigaku. 2008 Mar;48(3):179-83. doi: 10.5692/clinicalneurol.48.179.

Abstract

We reported a 51-year-old woman with Gerstmann-Sträussler-Scheinker syndrome (GSS P102L) manifesting characteristic MRI findings. At the age of 45, She developed gait disturbance with muscle atrophy in the lower limbs and positive plantar flexor sign. Subsequently, sensory disturbance such as refractory pain in the lower limbs and ataxic gait were developed at the age of 49. Following these clinical symptoms, she finally demonstrated rapid progressive cognitive dysfunction. Just after presenting cognitive dysfunction, cranial MRI was performed. Cranial MRI with diffusion-weighted imaging and FLAIR imaging demonstrated abnormal high intensity lesions in the bilateral pulvinar, caudate nuclei and cerebral cortex. The degree of high signal at the pulvinar was less than those of the cortex and caudate nuclei. A proline-for-leucine substitution at codon 102 of the prion protein gene was demonstrated. These results allowed the diagnosis of GSS (P102L). This is a rare case of GSS (P102L) presenting with high intensity lesions in the bilateral pulvinar on MRI.

摘要

我们报告了一例51岁患有格斯特曼-施特劳斯勒-谢inker综合征(GSS P102L)的女性,其具有特征性的MRI表现。45岁时,她出现步态障碍,伴有下肢肌肉萎缩和跖屈征阳性。随后,49岁时出现下肢顽固性疼痛等感觉障碍和共济失调步态。出现这些临床症状后,她最终表现出快速进展的认知功能障碍。在出现认知功能障碍后不久,进行了头颅MRI检查。头颅MRI的弥散加权成像和液体衰减反转恢复成像显示双侧丘脑枕、尾状核和大脑皮质有异常高信号病变。丘脑枕的高信号程度低于皮质和尾状核。在朊蛋白基因第102密码子处发现脯氨酸替代亮氨酸。这些结果确诊为GSS(P102L)。这是一例罕见的GSS(P102L)病例,MRI显示双侧丘脑枕有高信号病变。

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