Yusupov Arkady, Galvin James E
Alzheimer Disease Center, Departments of Neurology, Psychiatry and Population Health, New York University Langone Medical Center, New York, N.Y., USA.
Case Rep Neurol. 2014 Apr 30;6(1):126-33. doi: 10.1159/000362159. eCollection 2014 Jan.
Vocalizations are part of the spectrum of the 'negative' behavioral and psychological symptoms of dementia (BPSD). We describe a patient with moderate-stage mixed dementia of Alzheimer's disease and cerebrovascular disease and a left orbitofrontal lesion exhibiting vocalization. The use of 'redirection' has been demonstrated to be an effective nonpharmacological means of controlling BPSD, while reducing caregiver distress.
A 78-year-old right-handed African-American female presented with complaints of worsening memory and BPSD, causing significant caregiver distress. Throughout the evaluation, she constantly vocalized her son's name and made a continuous grunting noise, correlating with increased anxiety/agitation. We utilized a redirection technique, which achieved the immediate reduction of the vocalization symptoms. Caregiver psychoeducation was provided allowing them to use the redirection technique at home.
In patients with dementia exhibiting negative symptoms of BPSD, using nonpharmacologic techniques (i.e. redirection) may be indicated. Psychotropic medications rarely address negative BPSD symptoms, while simultaneously decreasing patient's quality of life. Nonpharmacologic approaches are beneficial as first-line therapy for negative BPSD.
发声是痴呆症“负面”行为和心理症状（BPSD）的一部分。我们描述了一名患有中度阿尔茨海默病和脑血管病混合性痴呆且左侧眶额病变的患者出现发声症状。“重新定向”已被证明是控制BPSD的一种有效的非药物手段，同时可减轻照料者的痛苦。
一名78岁右利手非裔美国女性，主诉记忆力恶化和BPSD，给照料者带来极大痛苦。在整个评估过程中，她不断呼喊儿子的名字并持续发出呼噜声，这与焦虑/激动情绪加剧相关。我们采用了重新定向技术，该技术使发声症状立即减轻。我们为照料者提供了心理教育，以便他们在家中使用重新定向技术。
对于表现出BPSD负面症状的痴呆患者，可能需要使用非药物技术（即重新定向）。精神药物很少能解决BPSD的负面症状，同时还会降低患者的生活质量。非药物方法作为BPSD负面症状的一线治疗方法是有益的。
