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作为阿尔茨海默病晚期表现出现的运动障碍,由低剂量卡马西平控制。

Movement Disorders that Occurred as Late Manifestations of Alzheimer's Disease Controlled by a Low dose of Carbamazepine.

作者信息

Manckoundia Patrick, Vovelle Jérémie, Cancemi Sylvia, Mahmoudi Rachid, Renoncourt Thomas

机构信息

Department of Geriatrics and Internal Medicine, Champmaillot Hospital, University Hospital, Dijon, France.

UMR Inserm/U1093 Cognition, Action, Sensorimotor Plasticity, University of Burgundy and Franche Comté, Dijon, France.

出版信息

Eur J Case Rep Intern Med. 2024 Dec 16;11(12):004943. doi: 10.12890/2024_004943. eCollection 2024.

Abstract

INTRODUCTION

According to the World Health Organization, 44 million people worldwide suffer from Alzheimer's disease. Abnormal movements are atypical symptoms of Alzheimer's disease.

CASE DESCRIPTION

An 87-year-old woman, followed for Alzheimer's disease, experienced abnormal movements. The episodes lasted 30 minutes, were involuntary, uncontrollable, anarchic, predominantly in the upper limbs, and without loss of consciousness or bladder control. An electroencephalogram ruled out atypical epilepsy. Pharmacovigilance investigation ruled out a drug-related cause. Magnetic resonance imaging revealed abnormalities suggestive of Alzheimer's disease, with no other evidence to explain the abnormal movements. Apart from the presence of Alzheimer's disease biomarkers, cerebrospinal fluid analysis found no abnormality. Dopamine transporter scan rule out an atypical parkinsonian syndrome. Finally, abnormal movements associated with Alzheimer's disease were suspected. Abnormal movements disappeared within 72 hours on low-dose carbamazepine.

CONCLUSION

This case is educational both because of the clinical presentation and the management of symptoms.

LEARNING POINTS

The number of people suffering from Alzheimer's disease, the leading cause of major neurocognitive disorders, is expected to reach around 78 million in 2030 and 139 million in 2050.The course of Alzheimer's disease may be punctuated by atypical symptoms, such as abnormal movements.In patients on carbamazepine, we observed a dramatic improvement in abnormal movements associated with Alzheimer's disease.

摘要

引言

根据世界卫生组织的数据,全球有4400万人患有阿尔茨海默病。异常运动是阿尔茨海默病的非典型症状。

病例描述

一名87岁患有阿尔茨海默病的女性出现了异常运动。发作持续30分钟,为不自主、无法控制、无规律的,主要发生在上肢,且无意识丧失或膀胱控制障碍。脑电图排除了非典型癫痫。药物警戒调查排除了药物相关原因。磁共振成像显示有提示阿尔茨海默病的异常,但没有其他证据可以解释异常运动。除了存在阿尔茨海默病生物标志物外,脑脊液分析未发现异常。多巴胺转运体扫描排除了非典型帕金森综合征。最后,怀疑是与阿尔茨海默病相关的异常运动。低剂量卡马西平治疗后,异常运动在72小时内消失。

结论

该病例在临床表现和症状管理方面都具有教育意义。

学习要点

作为主要神经认知障碍的主要病因,预计到2030年,患有阿尔茨海默病的人数将达到约7800万,到2050年将达到1.39亿。阿尔茨海默病的病程可能会出现非典型症状,如异常运动。在服用卡马西平的患者中,我们观察到与阿尔茨海默病相关的异常运动有显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b12/11716315/46e16341a8af/4943_Fig1.jpg

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