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病例报告:克雅氏病:一例以强迫状态发作为起始的病例。

Case report: Creutzfeldt-Jakob disease: a case that initiated with the onset of obsessive-compulsive state.

作者信息

Li Baizhu, Wang Shan, Han Shiyu, Hu Ning, Shang Xiuli

机构信息

The First Affiliated Hospital of China Medical University, Shenyang, China.

出版信息

Front Neurol. 2023 Jul 18;14:1227566. doi: 10.3389/fneur.2023.1227566. eCollection 2023.

Abstract

BACKGROUND

Obsessive-compulsive disorder (OCD) is a common reason for patients to seek symptomatic treatment in psychiatric departments, which makes it challenging to consider underlying organic nervous system diseases. However, Creutzfeldt-Jakob disease (CJD) can present with atypical symptoms, sometimes even as initial symptoms, leading to misdiagnosis or missed diagnosis. Lumbar puncture and brain DWI are important diagnostic methods for CJD, and the detection of 1,433 protein can be performed to confirm the diagnosis.

CASE PRESENTATION

We present the case of a 63-year-old woman who was initially diagnosed with obsessive-compulsive disorder in 2022. Despite seven months of symptomatic treatment, her symptoms did not improve. She also developed symptoms of altered consciousness, such as upper limb tremors and mutism. Based on brain DWI and positive results from the detection of 1,433 protein, she was ultimately diagnosed with CJD.

CONCLUSION

Creutzfeldt-Jakob disease (CJD) can manifest initially as obsessive-compulsive disorder (OCD) with atypical symptoms, making it prone to misdiagnosis. Therefore, it is crucial to conduct further investigations, including lumbar puncture and imaging, to exclude organic nervous system diseases before initiating symptomatic treatment for psychiatric disorders. This approach can facilitate early diagnosis of CJD and other potential organic neurological diseases.

摘要

背景

强迫症(OCD)是患者到精神科寻求对症治疗的常见原因,这使得考虑潜在的器质性神经系统疾病具有挑战性。然而,克雅氏病(CJD)可表现出非典型症状,有时甚至作为首发症状,导致误诊或漏诊。腰椎穿刺和脑部弥散加权成像(DWI)是诊断CJD的重要方法,检测14-3-3蛋白可用于确诊。

病例介绍

我们报告一例63岁女性病例,该患者于2022年最初被诊断为强迫症。尽管进行了7个月的对症治疗,其症状并未改善。她还出现了意识改变的症状,如上肢震颤和缄默。基于脑部DWI以及14-3-3蛋白检测呈阳性结果,她最终被诊断为CJD。

结论

克雅氏病(CJD)最初可表现为伴有非典型症状的强迫症(OCD),容易误诊。因此,在对精神障碍进行对症治疗之前,进行包括腰椎穿刺和影像学检查在内的进一步检查以排除器质性神经系统疾病至关重要。这种方法有助于早期诊断CJD和其他潜在的器质性神经疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/309c/10391538/6dde95654895/fneur-14-1227566-g0001.jpg

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