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[拉福拉样包涵体病例的临床与组织病理学研究]

[Clinical and histopathological studies of cases of lafora-like inclusion bodies].

作者信息

Yoshimura T

出版信息

Folia Psychiatr Neurol Jpn. 1977;31(1):89-102.

PMID:193769
Abstract

In case 1, 41-year-old male, developed progressive demetia, paretic gait disturbance and pyramidal signs with the duration of three years. The neuropathological study revealed systemic atrophy as type Pick-disease i.e., lobal atrophy in the frontal and the parieto-occipital regions, degenerative changes in the basal ganglia and in the thalamus, nerve cell loss in the substantia nigra and myelin pallor in the pyramidal tract. Lafora-like inclusions were found in the cerebral cortex and in the cochleal nucleus. In case 2, 45-year-old male, showed character change, cerebellar symptomes and mental deteriotation, and ulcers on the oral mucosa during about 15 years long period. Neuropathological examination showed chronic encephalitis in the brain stem, vacuolar change in the neuron in the olivary nucleus and Lafora-like inclusions in the cochlear nucleus. Though neither generalized conversion nor myoclonus were clinicaly observed in these cases, the inclusions showed histochemically strong similarity with that of the Lafora-disease. These Lafora-like inclusions were compared with those in the literatur, which were reported on various disease of CNS. Finally in respect of predilection of the inclusions, it is likely that the inclusions result from same metabolic disturbance in the cochlear neurons in the Lafora-disease as well as in the present cases.

摘要

病例1为一名41岁男性,出现进行性痴呆、偏瘫步态障碍和锥体束征,病程3年。神经病理学研究显示为系统性萎缩,符合匹克病类型,即额叶和顶枕叶区域的叶性萎缩、基底神经节和丘脑的退行性改变、黑质神经细胞丢失以及锥体束髓鞘苍白。在大脑皮层和蜗神经核中发现了类拉福拉小体。病例2为一名45岁男性,在约15年的时间里出现性格改变、小脑症状和智力衰退,以及口腔黏膜溃疡。神经病理学检查显示脑干有慢性脑炎、橄榄核神经元有空泡样改变以及蜗神经核有类拉福拉小体。尽管在这些病例中临床上未观察到全身性惊厥或肌阵挛,但这些包涵体在组织化学上与拉福拉病的包涵体有很强的相似性。将这些类拉福拉小体与文献中报道的中枢神经系统各种疾病中的进行了比较。最后,就包涵体的偏好而言,这些包涵体很可能与拉福拉病以及本病例中的蜗神经节神经元的相同代谢紊乱有关。

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