del Ser T, Iriarte I, Pondal M, Molina J A
Sección de Neurología, Hospital Severo Ochoa, Leganés, Madrid.
Neurologia. 1990 Aug-Sep;5(7):246-50.
Hypothyroidism is one of the most frequent causes of treatable symptomatic dementia. However a detailed description of its neuropsychologic characteristics in the medical literature is lacking. We have studied a 70 year old patient suffering severe mental deterioration, cerebellopathy, myopathy and hypothyroidism with a complete set of neuropsychologic and psychometric tests: mental mini-examination, Blessed's scale, neuropsychologic examination, WAIS, Bento visual retention test, Rey's picture, words learning, delayed recall of words, verbal fluency, reaction times and maintained attention. This type of dementia is characterized by a low score in all tests which improves progressively with the treatment and it is also accompanied by a lack of language defects, nonconstructive apraxia or agnosia. The recovery involves the attentional field and the memory as well as the two intelligence indices. However this improvement is more apparent in the tests related to attention and visuospatial information processing. It is concluded that hypothyroid dementia in this patient had characteristics "subcortical dementia" and a neuropsychologic deterioration pattern rather nonspecific with a slight predominance of the attentional and visuospatial defects.
甲状腺功能减退症是可治疗的症状性痴呆最常见的病因之一。然而,医学文献中缺乏对其神经心理学特征的详细描述。我们对一名70岁的患者进行了研究,该患者患有严重的精神衰退、小脑病变、肌病和甲状腺功能减退症,并进行了全套神经心理学和心理测量测试:简易精神状态检查、Blessed量表、神经心理学检查、韦氏成人智力量表、本托视觉保持测验、雷氏图形、单词学习、单词延迟回忆、语言流畅性、反应时间和持续注意力测试。这种类型的痴呆症在所有测试中得分较低,随着治疗逐渐改善,并且还伴有无语言缺陷、非建设性失用症或失认症。恢复涉及注意力领域、记忆力以及两个智力指标。然而,这种改善在与注意力和视觉空间信息处理相关的测试中更为明显。结论是,该患者的甲状腺功能减退性痴呆具有“皮质下痴呆”的特征,神经心理学衰退模式相当不特异,注意力和视觉空间缺陷略有占优。