Milder D G, Elliott C F, Evans W A
Clin Exp Neurol. 1984;20:181-7.
A 66-year-old man was investigated for increasing forgetfulness and frequent falls. Following appropriate investigations, the cause was presumed to be senile dementia of the Alzheimer type. He was reviewed one year later and found to have impaired vertical gaze and a hoarse voice. Progressive dementia, nuchal rigidity, anarthria, and sphincteric incontinence developed subsequently. A diagnosis of progressive supranuclear palsy was made. He died four years after the initial assessment. Neuropathological examination revealed changes characteristic of progressive supranuclear palsy, and suggestive of Alzheimer's disease. Globose tangles, granulovacuolar bodies and gliosis were present in the midbrain, the pons, the dentate nucleus of the cerebellum, and the globus pallidus. Senile plaques and occasional neurofibrillary tangles and granulovacuolar bodies were found in the hippocampus, amygdala, and temporal cortex. The coexistence of two disease processes resulting in dementia is discussed.
一名66岁男性因记忆力减退和频繁跌倒接受检查。经过适当检查后，病因推测为阿尔茨海默型老年痴呆症。一年后对他进行复查时，发现他存在垂直凝视障碍和声音嘶哑。随后出现了进行性痴呆、颈部强直、构音障碍和括约肌失禁。最终诊断为进行性核上性麻痹。初次评估四年后他去世。神经病理学检查显示出进行性核上性麻痹的特征性变化，且提示存在阿尔茨海默病。中脑、脑桥、小脑齿状核和苍白球出现了球状缠结、颗粒空泡体和神经胶质增生。在海马体、杏仁核和颞叶皮质发现了老年斑以及偶尔的神经原纤维缠结和颗粒空泡体。本文讨论了导致痴呆的两种疾病过程并存的情况。
