Nakano T, Iwabuchi K, Yagishita S, Amano N, Akagi M, Yamamoto Y
No To Shinkei. 1985 Aug;37(8):767-74.
An autopsy case of a 65-year-old female with dentatorubropallidoluysian atrophy (DRPLA) is reported. Her mother had gait disturbance and died at the age of 63. Her mother's brother developed psychotic symptoms. A daughter of her older sister was observed to have involuntary movement when she admitted to a mental hospital due to post-delivery psychotic state. Her younger brother has developed gait disturbance from about 56-year-old. Her older son has suffered from schizophrenia for long years. Since 58-year-old, she developed cerebellar ataxic gait and three years later, choreic involuntary movement developed in her extremities and face and progressively became prominent. Since 63-year-old, abnormal behavior brought about by the visual hallucination was occasionally observed. At the age of 63, she admitted to a mental hospital because of persistent persecutive delusion for her husband and was clinically diagnosed as Huntington's chorea for her remarkable choreic movement and psychotic state with dementia. Hypertension was also noticed. At the age of 65, she died of acute pneumonia. The duration of her illness was about 6 years. Histopathological findings of the CNS: the brain weighed 1,014 g. Brainstem and spinal cord were noticed to be relatively small in size. The cerebral cortex was well preserved. The cerebral white matter was diffusely demyelinated in the central semiovale where arteriosclerotic change of the small vessels was remarkable. Significant pathological changes consisted of marked symmetrical atrophy of the following two systems, i. e., dentatofugal pallidoluysian systems.(ABSTRACT TRUNCATED AT 250 WORDS)
报告了一例65岁患有齿状核红核苍白球路易体萎缩症(DRPLA)的女性尸检病例。她的母亲有步态障碍,63岁时去世。她母亲的兄弟出现了精神症状。她姐姐的一个女儿在因产后精神病状态入住精神病院时被观察到有不自主运动。她的弟弟从大约56岁开始出现步态障碍。她的大儿子长期患有精神分裂症。58岁起,她出现小脑性共济失调步态,三年后,四肢和面部出现舞蹈样不自主运动,并逐渐加重。63岁起,偶尔观察到由视幻觉引起的异常行为。63岁时,她因对丈夫持续的被害妄想入住精神病院,因其显著的舞蹈样运动和伴有痴呆的精神病状态被临床诊断为亨廷顿舞蹈病。还发现有高血压。65岁时,她死于急性肺炎。病程约6年。中枢神经系统的组织病理学发现:脑重1014克。脑干和脊髓体积相对较小。大脑皮质保存完好。大脑白质在半卵圆中心弥漫性脱髓鞘,小血管有明显的动脉硬化改变。显著的病理变化包括以下两个系统明显的对称性萎缩,即齿状核-苍白球-路易体系统。(摘要截断于250字)