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牙科手术后发生克雅氏病并伴有精神障碍的初始表现:一例报告

Creutzfeldt-Jakob Disease after Dental Procedure along with the Initial Manifestations of Psychiatric Disorder: A Case Report.

作者信息

Badrfam Rahim, Noorbala Ahmad Ali, Vahabi Zahra, Zandifar Atefeh

机构信息

Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Psychosomatic Ward, Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Psychiatry. 2021 Jan;16(1):106-110. doi: 10.18502/ijps.v16i1.5385.

Abstract

Creutzfeldt-Jakob disease (CJD) as a prion disease is an untreatable type of progressive neurodegenerative encephalopathy. Although no definitive case has been reported yet, here we report a case that given the history, course of symptoms, and recent dental practice, it is highly probable that it was caused by dental procedures. The patient was a 52-year-old woman who has had memory problems gradually with forgetting the names of family members since 6 weeks prior to the visit and shortly after the dental procedure. She experienced progressive visual hallucinations accompanied by a sharp decline in cognitive, verbal, and motor abilities in just a few weeks. Finally, the diagnosis of Creutzfeldt-Jakob was made for her based on the clinical history and typical brain MRI. Clinical evidence of this patient, along with positive brain MRI results, indicates the risk of prion transfer through dental procedures. Paying attention to the neurological aspects of psychiatric manifestations and increasing the awareness of dentists about how to deal with and act on the potential dangers of prion transfer is of paramount importance.

摘要

克雅氏病(CJD)作为一种朊病毒病,是一种无法治疗的进行性神经退行性脑病。尽管尚未报告确诊病例,但在此我们报告一例,鉴于病史、症状病程以及近期的牙科诊疗操作,极有可能是由牙科手术引起的。患者为一名52岁女性,自就诊前6周以及牙科手术后不久,便逐渐出现记忆问题,开始忘记家庭成员的名字。在短短几周内,她出现了进行性视幻觉,并伴有认知、语言和运动能力的急剧下降。最终,根据临床病史和典型的脑部MRI检查结果,她被诊断为克雅氏病。该患者的临床证据以及脑部MRI检查结果呈阳性,表明存在通过牙科手术传播朊病毒的风险。关注精神症状的神经学方面,并提高牙医对如何应对朊病毒传播潜在危险以及采取相应行动的认识至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20fa/8140296/3a8482cf96ba/IJPS-16-106-g001.jpg

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