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[以运动神经元变性和进行性假性球麻痹为特征的肌萎缩侧索硬化症尸检病例]

[An Autopsy Case of Amiotrophic Lateral Sclerosis Characterized by Upper Motor Neuron Degeneration and Progressive Pseudobulbar Palsy].

作者信息

Kikuchi Raita, Ishihara Kenji, Nagumo Kiyomi, Sioda Junichi, Kawamura Mitsuru, Yoshida Mari

机构信息

Department of Neurology, Ushioda General Hospital.

出版信息

Brain Nerve. 2019 Jan;71(1):75-80. doi: 10.11477/mf.1416201219.

Abstract

This is a case report of autopsy findings for a male Japanese patient who presented with progressive gait disturbance and dysarthria. Neurological examination at the age of 61 years revealed pseudobulbar palsy and upper motor neuron disorder. The patient appeared unaware of his illness. Electrophysiological examination showed lower neuron damage. The patient was diagnosed with amyotrophic lateral sclerosis characterized by lower motor neuron damage. He died of pneumonia 2 years and 3 months after diagnosis. Neuropathological examination demonstrated severe degeneration of the upper neurons and mild degeneration of the lower neurons. Immunohistological examination indicated transactivation-responsive DNA-binding protein-43-positive pathology in the frontal and temporal lobes, amygdala, corpus striatum, and spinal cord. We believe the neuropathological findings correlate well with the clinical features. Furthermore, we also discuss the lesions involved in the patient's dementia. (Received March 28, 2017; Accepted September 19, 2018; Published November 1, 2018).

摘要

这是一份针对一名日本男性患者尸检结果的病例报告,该患者表现为进行性步态障碍和构音障碍。61岁时的神经学检查显示假性延髓麻痹和上运动神经元疾病。患者似乎未意识到自己的病情。电生理检查显示下运动神经元损伤。该患者被诊断为以运动神经元损伤为特征的肌萎缩侧索硬化症。诊断后2年零3个月,他死于肺炎。神经病理学检查显示上运动神经元严重退化,下运动神经元轻度退化。免疫组织学检查表明额叶、颞叶、杏仁核、纹状体和脊髓存在反式激活反应性DNA结合蛋白43阳性病变。我们认为神经病理学发现与临床特征密切相关。此外,我们还讨论了该患者痴呆症所涉及的病变。(2017年3月28日收到;2018年9月19日接受;2018年11月1日发表)

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