非惊厥性发作酷似克雅氏病，伴 MRI 异常快速缓解和复发。
Non-convulsive Seizures Mimicking Creutzfeldt-Jakob Disease with Rapid Resolution and Recurrence of MRI Abnormalities.
机构信息
Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (KH).
Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH (RS).
出版信息
Hawaii J Health Soc Welf. 2022 Feb;81(2):31-33.
An 88-year-old man presented with acute altered mental status. Brain magnetic resonance imaging (MRI) demonstrated "cortical ribboning," which is classically associated with Creutzfeldt-Jakob disease. His rapid clinical improvement prompted a follow-up MRI three days after presentation, which showed resolution of the acute abnormal signals. The patient was eventually diagnosed with non-convulsive seizure. Five months later, he returned with a similar clinical presentation and MRI findings after self-discontinuation of anticonvulsant. It is important for clinicians to be aware that neurological changes associated with non-convulsive seizures can acutely mimic Creutzfeldt-Jakob disease, and to consider a short interval follow-up MRI for diagnostic challenges in acute settings.
一位 88 岁男性因急性意识改变就诊。脑部磁共振成像（MRI）显示“皮质条纹征”，这与克雅氏病（Creutzfeldt-Jakob disease）密切相关。他的病情迅速改善，促使在就诊后三天进行了后续 MRI 检查，结果显示急性异常信号已消退。最终，该患者被诊断为非惊厥性发作。五个月后，他在自行停用抗癫痫药物后出现类似的临床和 MRI 表现。临床医生需要注意，非惊厥性发作相关的神经功能变化可能会急性模拟克雅氏病，在急性情况下，应考虑进行短期间隔的 MRI 随访以进行诊断。
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