Neumann P E, Mehler M F, Horoupian D S, Merriam A E
Department of Pathology, Albert Einstein College of Medicine, Bronx, NY.
Arch Neurol. 1988 Jun;45(6):634-6. doi: 10.1001/archneur.1988.00520300052018.
A 34-year-old woman experienced three episodes of an atypical psychosis, characterized by confusion, agitation, delusional thinking, paranoid ideation, and auditory hallucinations, during the 14 months prior to her death. Findings of gross examination of the brain and spinal cord were unremarkable. Histologic examination revealed scattered subpial foci of demyelination throughout the brain stem, with involvement of the hippocampal formation bilaterally. Although occasional active lesions at early stages of development were noted, most lesions were gliotic and therefore quiescent. This case and one similar example of disseminated subpial demyelination found in the literature probably represent an unusual variant of multiple sclerosis.
一名34岁女性在死前14个月内经历了三次非典型精神病发作，其特征为意识模糊、躁动、妄想思维、偏执观念和幻听。脑和脊髓大体检查结果无明显异常。组织学检查显示，脑干有散在的软膜下脱髓鞘病灶，双侧海马结构也受累。虽然在病变发展早期偶尔可见活动性病损，但大多数病损为胶质化，因此处于静止状态。该病例以及文献中发现的另一例播散性软膜下脱髓鞘病例可能代表了多发性硬化症的一种罕见变异型。
