Kaphan Elsa, Barbeau Emmanuel, Royère Marie L, Guedj Eric, Pelletier Jean, Ali Chérif André
Service de Neurologie, Pôle de Neurosciences cliniques, AP-HM Timone, Marseille 13005, France
Service de Neurologie et Neuropsychologie, Faculté de Médecine, Pôle de Neurosciences cliniques, AP-HM Timone and LNN INSERM U751, Marseille 13005, France.
Arch Clin Neuropsychol. 2014 Nov;29(7):715-23. doi: 10.1093/arclin/acu046. Epub 2014 Oct 3.
Very few data are available on the long-term changes in the cognitive abilities of patients with loss of psychic self-activation syndrome (LPSAS). Here, we present a 25-year follow-up study on a case of LPSAS resulting from bilateral pallidal lesions caused by carbon monoxide intoxication. Typical signs of LPSAS were observed, showing no changes in severity, but Ganser syndrome (GS) gradually developed and worsened during the follow-up period. GS is generally assumed to be a psychogenic syndrome, but an organic etiology has been suspected by the authors of several case reports. Here, atypical features of GS plead against the independence of GS and LPSAS. DaTSCAN and brain 18FDG-PET were performed. Since left hippocampal hypometabolism has been previously described in patients with functional amnesia, it is possible that long periods of mental inactivity may have psychological consequences, but the atypical features of GS also suggest that an organic mechanism may be involved.
关于精神自我激活综合征（LPSAS）患者认知能力的长期变化，目前可用的数据非常少。在此，我们报告一例因一氧化碳中毒导致双侧苍白球病变引起的LPSAS患者的25年随访研究。观察到LPSAS的典型症状，严重程度无变化，但在随访期间甘塞尔综合征（GS）逐渐发展并恶化。GS通常被认为是一种心因性综合征，但一些病例报告的作者怀疑其存在器质性病因。在此，GS的非典型特征不支持GS与LPSAS的独立性。进行了DaTSCAN和脑18FDG - PET检查。由于先前已描述功能性失忆症患者存在左侧海马代谢减低，长时间精神活动减退可能产生心理后果，但GS的非典型特征也提示可能涉及器质性机制。
