Xu Ting, Mei Xi, Zhao Zheng, Liu Yue-Hong, Zheng Cheng-Ying
Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University, Ningbo 315201, Zhejiang Province, China.
World J Psychiatry. 2024 Sep 19;14(9):1404-1410. doi: 10.5498/wjp.v14.i9.1404.
Perception is frequently impaired in patients with Alzheimer's disease (AD). Several patients exhibit visual or haptic hallucinations.
A 71-year-old Chinese man presented with visual and haptic hallucinations he had been experiencing for 2 weeks. The clinical manifestations were the feeling of insects crawling and biting the limbs and geison. He looked for the insects while itching and scratching, which led to skin breakage on the limbs. He was treated with topical and anti-allergic drugs in several dermatology departments without any significant improvement. After admission, the patient was administered risperidone (0.5 mg) and duloxetine (2 mg/day). One week later, the dose of risperidone was increased to 2 mg/day, and that of duloxetine was increased to 60 mg/day. After 2 weeks of treatment, the patient's sensation of insects crawling and biting disappeared, and his mood stabilized.
This patient manifested psychiatric behavioral symptoms caused by AD brain atrophy. It was important to re-evaluate the patient's cognitive-psychological status when the patient repeatedly went to the hospital for treatment. Follow-up attention to cognitive function and the consideration of perceptual deficits as early manifestations of AD should be considered.
阿尔茨海默病（AD）患者的感知功能常受损。部分患者会出现视幻觉或幻触。
一名71岁中国男性，出现视幻觉和幻触症状达2周。临床表现为感觉有昆虫在四肢和躯干部位爬行和叮咬。他在瘙痒抓挠时寻找昆虫，导致四肢皮肤破损。他在多个皮肤科就诊，接受了外用及抗过敏药物治疗，但均无明显改善。入院后，给予患者利培酮（0.5毫克）和度洛西汀（2毫克/天）。一周后，利培酮剂量增至2毫克/天，度洛西汀剂量增至60毫克/天。经过2周治疗，患者的昆虫爬行和叮咬感消失，情绪稳定。
该患者表现出由AD脑萎缩引起的精神行为症状。当患者反复就医时，重新评估其认知心理状态很重要。应考虑对认知功能进行随访关注，并将感知缺陷视为AD的早期表现。
