老年精神分裂症患者帕金森综合征病因的充分诊断与治疗：一例报告
Adequate diagnosis of the cause of Parkinsonism and treatment in an elderly patient with schizophrenia: A case report.
作者信息
Yoshioka Daisuke, Yamanashi Takehiko, Iwata Masaaki
机构信息
Division of Neuropsychiatry, Faculty of Medicine Tottori University Yonago Japan.
出版信息
PCN Rep. 2023 Jan 9;2(1):e71. doi: 10.1002/pcn5.71. eCollection 2023 Mar.
BACKGROUND
Parkinsonism is frequently observed in patients with schizophrenia, and most patients are diagnosed with drug-induced parkinsonism. However, comorbidity with idiopathic Parkinson's disease or Parkinson-plus syndrome is also possible. The pathophysiology and treatment for each of these are entirely different, thus an appropriate diagnosis is required. However, distinguishing them based on clinical symptoms alone is often difficult, and many cases are misdiagnosed. Additionally, Parkinsonism is frequently mistaken for negative symptoms.
CASE DESCRIPTION
We report a case of 68-year-old woman diagnosed with schizophrenia, who was admitted to a welfare center. At approximately age 60, the patient experienced motivation reduction, a loss of appetite, and pain in the extremities. In her mid-60s, tremor and muscle rigidity appeared; nuclear medicine testing was performed for a detailed examination, resulting in a diagnosis of levodopa-responsive Parkinson's syndrome. Notably, the patient's parkinsonism and emotional symptoms, which had been considered negative symptoms thus far, improved with levodopa treatment.
CONCLUSION
This case report illustrates the importance of properly diagnosing the cause of parkinsonism in patients with schizophrenia.
背景
帕金森症在精神分裂症患者中经常出现，大多数患者被诊断为药物性帕金森症。然而，与特发性帕金森病或帕金森叠加综合征合并存在也是有可能的。这些病症各自的病理生理学和治疗方法完全不同，因此需要进行恰当的诊断。然而，仅根据临床症状来区分它们往往很困难，许多病例被误诊。此外，帕金森症常常被误诊为阴性症状。
病例描述
我们报告一例68岁被诊断为精神分裂症的女性患者，她入住了一家福利院。大约在60岁时，患者出现动力减退、食欲不振和四肢疼痛。在她60多岁时，出现了震颤和肌肉僵硬；进行了核医学检查以进行详细评估，结果诊断为左旋多巴反应性帕金森综合征。值得注意的是，患者的帕金森症和一直以来被认为是阴性症状的情绪症状，在接受左旋多巴治疗后有所改善。
结论
本病例报告说明了正确诊断精神分裂症患者帕金森症病因的重要性。
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