Das Soumitra, Sadh Kamaldeep, Chatterjee Seshadri Sekhar, Thirthalli Jagadisha
North Western Mental Health, Melbourne Health, Melbourne, Australia.
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Indian J Psychiatry. 2018 Jul-Sep;60(3):355-357. doi: 10.4103/psychiatry.IndianJPsychiatry_230_18.
Rapidly progressive dementia (RPD) is generally obvious to family member but often difficult for physicians to pinpoint the underlying pathology. Some common causes, such as prion's disease, Alzheimer's disease, central nervous system vasculitis, or infection, might present with disease-specific signs or symptoms where many etiologies do not produce such warning signs. Here, we are presenting a case who attended the psychiatric clinic for decreased motivation to do work, easy fatigability, infrequent falls, recent memory impairment, increased appetite, polydipsia and polyuria, and provisionally diagnosed with RPD. Magnetic resonance imaging revealed solid cystic lesion in suprasellar location involving hypothalamus, optic chiasma, and optic tracts, compressing the floor of the third ventricle suggestive of craniopharyngioma which is one of the very few reports in literature.
快速进展性痴呆（RPD）对家庭成员来说通常很明显，但医生往往难以确定其潜在病因。一些常见病因，如朊病毒病、阿尔茨海默病、中枢神经系统血管炎或感染，可能会出现特定疾病的体征或症状，而许多病因不会产生此类警示信号。在此，我们报告一例患者，该患者因工作动力下降、易疲劳、偶发跌倒、近期记忆力减退、食欲增加、多饮多尿而就诊于精神科门诊，初步诊断为RPD。磁共振成像显示鞍上区实性囊性病变，累及下丘脑、视交叉和视束，压迫第三脑室底部，提示颅咽管瘤，这是文献中极少数的报告之一。
