Elhusein Bushra, Mahgoub Omer Bakri, Khairi Abdalla
Psychiatry, Department of Medical Education, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar.
Psychiatry, Department of Medical Education, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
BMJ Case Rep. 2020 Mar 17;13(3):e233460. doi: 10.1136/bcr-2019-233460.
A 56-year-old man was brought to our hospital by his family, seeking medical treatment for the patient's long-standing progressive word-finding difficulties, forgetfulness, agitation and social withdrawal. After multiple previous physician consultations, the patient was mistakenly diagnosed with epilepsy and prescribed multiple anticonvulsants, to which his above mentioned symptoms were unresponsive. His condition progressed over the next 10 years, resulting in severe cognitive impairments and a complete dysfunctionality. An electroencephalogram (EEG) assessment revealed persistent spike and wave activity in the left temporal lobe. Brain MRI revealed multiple small bright T2 and fluid attenuated inversion recovery (FLAIR) foci within the white matter of both cerebral hemispheres surrounding the ventricular system, as well as some widening of extra-axial cerebrospinal fluid spaces. The patient was finally diagnosed with early-onset dementia and temporal lobe epileptiform abnormalities. This case emphasises the need for diagnostic consideration of dementia in cognitively impaired patients, even when they are not of an advanced age.
一名56岁男性被家人送至我院，因其长期存在进行性找词困难、健忘、易激惹及社交退缩而寻求治疗。此前患者曾多次咨询医生，却被误诊为癫痫，并开具了多种抗惊厥药物，但上述症状并未得到缓解。在接下来的10年里，他的病情逐渐进展，导致严重的认知障碍和完全功能失调。脑电图（EEG）评估显示左侧颞叶持续存在棘波和慢波活动。脑部MRI显示双侧脑室周围白质内有多个小的T2高信号及液体衰减反转恢复序列（FLAIR）病灶，以及脑外脑脊液间隙增宽。该患者最终被诊断为早发性痴呆和颞叶癫痫样异常。此病例强调，即使是未到高龄的认知障碍患者，也需要考虑痴呆的诊断。
