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一例表现为转换障碍的散发性克雅氏病病例。

A Case of Sporadic Creutzfeldt-Jakob Disease Presenting as Conversion Disorder.

作者信息

Yegya-Raman Nikhil, Aziz Rehan, Schneider Daniel, Tobia Anthony, Leitch Megan, Nwobi Onyi

机构信息

Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ, USA.

Psychiatry at Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ, USA.

出版信息

Case Rep Psychiatry. 2017;2017:2735329. doi: 10.1155/2017/2735329. Epub 2017 May 3.

Abstract

. Creutzfeldt-Jakob disease is a rare disorder of the central nervous system. Its initial diagnosis may be obscured by its variable presentation. This case report illustrates the complexity of diagnosing this disease early in the clinical course, especially when the initial symptoms may be psychiatric. It offers a brief review of the literature and reinforces a role for consultation psychiatry services. . PUBMED/MEDLINE was searched using the terms "Creutzfeldt-Jakob disease", "psychiatric symptoms", "conversion disorder", "somatic symptom disorder", "functional movement disorder", and "functional neurologic disorder". . The patient was a 64-year-old woman with no prior psychiatric history who was initially diagnosed with conversion disorder and unspecified anxiety disorder but soon thereafter was discovered to have Creutzfeldt-Jakob disease. . This case highlights the central role of psychiatric symptoms in early presentations of Creutzfeldt-Jakob disease. Still, few other cases in the literature report functional neurological symptoms as an initial sign. The consultation psychiatrist must remain alert to changing clinical symptoms, especially with uncharacteristic disease presentations.

摘要

克雅氏病是一种罕见的中枢神经系统疾病。其初始诊断可能因其表现多样而受到影响。本病例报告说明了在临床病程早期诊断这种疾病的复杂性,尤其是当初始症状可能为精神症状时。它简要回顾了文献,并强调了精神科会诊服务的作用。使用“克雅氏病”“精神症状”“转换障碍”“躯体症状障碍”“功能性运动障碍”和“功能性神经障碍”等术语在PUBMED/MEDLINE中进行了检索。该患者为一名64岁女性,既往无精神病史,最初被诊断为转换障碍和未特定的焦虑障碍,但此后不久被发现患有克雅氏病。本病例突出了精神症状在克雅氏病早期表现中的核心作用。然而,文献中很少有其他病例报告功能性神经症状为初始体征。精神科会诊医生必须对不断变化的临床症状保持警惕,尤其是在疾病表现不典型时。

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1
Psychogenic non-epileptic seizures in early Huntington's disease.早期亨廷顿舞蹈病中的心因性非癫痫性发作
Pract Neurol. 2016 Dec;16(6):452-454. doi: 10.1136/practneurol-2016-001423. Epub 2016 Jun 21.
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Rapid cognitive and functional decline: Creutzfeldt-Jakob disease.
JAAPA. 2013 Sep;26(9). doi: 10.1097/01.JAA.0000433963.28385.db.
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What psychiatrists should know about sporadic Creutzfeldt-Jakob disease.
Australas Psychiatry. 2012 Feb;20(1):61-6. doi: 10.1177/1039856211430145. Epub 2012 Jan 5.
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First symptom in sporadic Creutzfeldt-Jakob disease.散发性克雅氏病的首发症状。
Neurology. 2006 Jan 24;66(2):286-7. doi: 10.1212/01.wnl.0000196440.00297.67.

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