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克雅氏病:一例报告。

Creutzfeldt-Jakob disease: A case report.

作者信息

Salehian Razieh, Sina Farzad, Moudi Sussan

机构信息

Mental Health Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Department of Neurology, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Caspian J Intern Med. 2021;12(Suppl 2):S359-S362. doi: 10.22088/cjim.12.0.359.

Abstract

BACKGROUND

Creutzfeldt-Jakob disease (CJD) as a life-threatening neurodegenerative disorder is not usually diagnosed in early stages of the disease because of a variety in its clinical manifestations. This study aimed to present a middle-aged woman with psychiatric symptoms who ultimately was diagnosed as a CJD case.

CASE PRESENTATION

This 48-year-old woman had progressive symptoms of depressed mood, decreased sleep and appetite and mutism which started two months before the first visit. Gradually, slowness in movements, dysarthria and decreased performance were observed. Subsequently, when antidepressant and antipsychotic drugs were prescribed other symptoms such as ataxia and rigidity manifested in the patient. The problem list which led to final confirmation of the disease included non-specific neuropsychological presentations, hypersignality in caudate and putamen areas in brain MRI, generalized high frequency sharp waves in EEG, and protein 14-3-3 identification in cerebrospinal fluid.

CONCLUSION

Although CJD is not a common disease, it should be considered in differential diagnoses whenever neuropsychological manifestations, especially progressive decline in cognition, along with symptoms such as visual hallucinations, myoclonus and ataxia are observed in the patient.

摘要

背景

克雅氏病(CJD)作为一种危及生命的神经退行性疾病,由于其临床表现多样,通常在疾病早期难以诊断。本研究旨在介绍一名出现精神症状的中年女性,最终被诊断为克雅氏病病例。

病例报告

这名48岁女性在首次就诊前两个月开始出现情绪低落、睡眠和食欲减退以及缄默等进行性症状。逐渐地,观察到运动迟缓、构音障碍和行为能力下降。随后,在使用抗抑郁药和抗精神病药物治疗时,患者出现了共济失调和强直等其他症状。最终确诊该疾病的问题清单包括非特异性神经心理学表现、脑部MRI检查中尾状核和壳核区域的高信号、脑电图中的广泛性高频尖波以及脑脊液中14-3-3蛋白的检测。

结论

尽管克雅氏病并不常见,但当患者出现神经心理学表现,尤其是认知功能进行性下降,以及视幻觉、肌阵挛和共济失调等症状时,在鉴别诊断中应考虑该病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6729/8559638/77b4351ecae6/cjim-12-359-g001.jpg

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