Vargas M E, Kupersmith M J, Savino P J, Petito F, Frohman L P, Warren F A
Department of Ophthalmology, New York University Medical Center, New York, USA.
Am J Ophthalmol. 1995 Apr;119(4):497-504. doi: 10.1016/s0002-9394(14)71237-1.
Although in the early stage of Creutzfeldt-Jakob disease most patients have obvious dementia, we found that the disease can be diagnosed in patients solely on the basis of a visual system disorder.
We examined three patients who initially complained of a nonspecific, insidious visual disturbance.
The three patients were found to have Creutzfeldt-Jakob disease, confirmed by histopathologic analysis. Each patient had a homonymous hemianopsia on the first neuro-ophthalmologic examination. The initial neurologic, neuroimaging, and electrophysiologic examinations were not conclusive. The subsequent rapid deterioration in the neurologic status, including dementia and typical electroencephalographic changes, was suggestive of Creutzfeldt-Jakob disease.
At onset of Creutzfeldt-Jakob disease, patients may have a homonymous hemianopsia despite normal results of magnetic resonance imaging of the brain and neurologic examination.
尽管在克雅氏病早期大多数患者有明显的痴呆症状，但我们发现仅根据视觉系统障碍就可对患者进行该病的诊断。
我们检查了三名最初主诉有非特异性、隐匿性视觉障碍的患者。
经组织病理学分析确诊这三名患者患有克雅氏病。在首次神经眼科检查时，每名患者均有同向偏盲。最初的神经学、神经影像学和电生理学检查结果并不明确。随后神经状态迅速恶化，包括出现痴呆和典型的脑电图变化，提示为克雅氏病。
在克雅氏病发病时，尽管脑部磁共振成像和神经学检查结果正常，但患者可能会出现同向偏盲。
