Pavlovic Aleksandar, Marley Justin, Sivakumar Velusamy
Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK.
BMJ Case Rep. 2011 Feb 2;2011:bcr0920103303. doi: 10.1136/bcr.09.2010.3303.
The authors present the case of a 68-year-old lady with a 35-year history of bipolar affective disorder (BPAD) type I, who developed frontotemporal dementia (FTD). Description of the psychopathology is illustrated with examples of patient's writings in order to demonstrate cognitive abilities at different stages. The diagnosis is supported by MRI and SPECT scans. The authors discuss the difficulties in differentiating the clinical presentation of chronic BPAD and FTD and examine the evidence for two important questions: Is there a relationship between BPAD and FTD and is there a relationship between lithium and risk of dementia? This is, to the best of our knowledge, the first reported SPECT scan finding in a case of frontotemporal dementia following chronic bipolar affective disorder.
作者报告了一例68岁女性患者，其患有I型双相情感障碍（BPAD）35年，之后发展为额颞叶痴呆（FTD）。通过患者书写示例阐述精神病理学表现，以展示不同阶段的认知能力。MRI和SPECT扫描结果支持该诊断。作者讨论了鉴别慢性BPAD和FTD临床表现的困难，并审视了两个重要问题的证据：BPAD与FTD之间是否存在关联，以及锂盐与痴呆风险之间是否存在关联？据我们所知，这是首例报道的慢性双相情感障碍后发生额颞叶痴呆病例的SPECT扫描结果。
