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未确诊的阿尔茨海默病中的感觉异常与抑郁

Dysesthesia and Depression in Undiagnosed Alzheimer's Disease.

作者信息

Klein Harrison J, Lomiguen Christine M, Carter Seth

机构信息

Medical Education, Lake Erie College of Osteopathic Medicine, Erie, USA.

Pathology, Lake Erie College of Osteopathic Medicine, Erie, USA.

出版信息

Cureus. 2023 Jun 11;15(6):e40264. doi: 10.7759/cureus.40264. eCollection 2023 Jun.

Abstract

Dysesthesia is an abnormal sensation typically described as tingling, burning, or itching. Dysesthesia may occur in the presence or absence of causative dermatologic or medical pathology. Sensory abnormalities have been well documented in patients suffering from Alzheimer's disease (AD), though reported abnormalities typically affect the olfactory, visual, and auditory systems. Research describing dysesthetic symptoms in AD is scarce. Major depressive disorder (MDD) is another phenomenon commonly associated with AD, though depressive symptoms are frequently masked by cognitive deficits. Less attention has been given to the reverse of this relationship, in which MDD masks the symptoms of AD. Here, we present a case of undiagnosed AD in a geriatric patient presenting with primary complaints of depression and dysesthesia. We then discuss the pathophysiology of dysesthesia, MDD, and AD, as well as how these entities may interact in a single patient. Lastly, we emphasize the importance of thorough history-taking and multi-specialty collaboration in the care of older adults.

摘要

感觉异常是一种异常感觉,通常表现为刺痛、灼痛或瘙痒。无论是否存在引起皮肤病或内科疾病的病理状况,均可发生感觉异常。尽管所报告的异常通常影响嗅觉、视觉和听觉系统,但在阿尔茨海默病(AD)患者中,感觉异常已有充分记录。描述AD中感觉异常症状的研究很少。重度抑郁症(MDD)是另一种与AD常见相关的现象,尽管抑郁症状常被认知缺陷所掩盖。对于这种关系的相反情况,即MDD掩盖AD症状,关注较少。在此,我们报告一例老年患者,以抑郁和感觉异常为主诉就诊,最终被诊断为未确诊的AD。然后,我们讨论感觉异常、MDD和AD的病理生理学,以及这些病症在单一患者中可能如何相互作用。最后,我们强调在老年人护理中进行全面病史采集和多专科协作的重要性。

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