Lechevalier B, Brandel J P, Eustache F, Schupp C, Chapon F, Viader F
Service de Neurologie, CHU, Caen.
Rev Neurol (Paris). 1988;144(8-9):508-11.
A 66 year-old woman presented with severe memory disorders followed several months later with tremor of Parkinsonian type of the right upper limb totally relieved by treatment with levodopa-benserazide. Four years later she was admitted with memory disturbances, temporospatial disorientation, constructional and ideatory apraxia, dressing apraxia and language difficulties. Eight years later she had become bed-ridden, with deviation of head and eyes towards the left, hypertonus tremor and stereotyped movements. Neuropathologic examination showed neuronal loss in substantia nigra and left locus ceruleus, dorsal nucleus of the pneumogastric nerve and Meynert's basal nuclei on both sides. Neurofibrillary tangles affected the peri-aqueductal grey matter and Lewy's bodies were observed in the substantia nigra. Neurofibrillary tangles and granulovacuolar degeneration together with senile plaques were numerous in the hippocampus, but senile plaques and neurofibrillary tangles were rare in the remainder of the cortex. Combined Alzheimer's disease and Parkinson's disease could be due to simple coincidence, one of the diseases possibly predisposing to the appearance of the other.
一名66岁女性出现严重记忆障碍,数月后右上肢出现帕金森型震颤,左旋多巴-苄丝肼治疗后完全缓解。四年后,她因记忆障碍、时空定向障碍、结构性和观念性失用症、穿衣失用症及语言困难入院。八年后,她卧床不起,头和眼向左偏斜,有张力亢进性震颤和刻板动作。神经病理学检查显示黑质、左侧蓝斑、迷走神经背核及双侧Meynert基底核有神经元丢失。神经原纤维缠结累及导水管周围灰质,黑质可见路易小体。海马中神经原纤维缠结、颗粒空泡变性及老年斑大量存在,但皮质其他部位老年斑和神经原纤维缠结少见。阿尔茨海默病和帕金森病合并可能是单纯巧合,其中一种疾病可能易诱发另一种疾病的出现。