Ikeda M, Tanabe H, Horino T, Komori K, Hirao K, Yamada N, Hashimoto M, Kazui H, Mori T
Department of Neuroscience, Hyogo Institute for Aging Brain and Cognitive Disorders.
Seishin Shinkeigaku Zasshi. 1995;97(3):179-92.
Pick's disease are more often complicated than Alzheimer's disease by behavioral disturbances such as social misconduct and stereotypy, that are troublesome and clinically difficult to manage. The purpose of this study was to investigate the possibility of improvement in care for patients with Pick's disease by using their presumably preserved procedural memory. Four inpatients and two outpatients with Pick's disease were studied. Case 1: A 54-year-old right-handed retired clerk presented with a 3-year history of increasing restlessness, word-finding difficulty and impaired comprehension of nominal terms. He was forced to retire from his work because of his social misconduct and incommunicability. On admission he wandered about the ward irritably, did not enter into any conversation, and destroyed all keys in the ward by putting a pencil into keyholes. Neuroradiological examination revealed circumscribed bilateral frontotemporal atrophy which was more marked on the left side. However, he has become more adaptive to the life in the ward and his expression has become peaceful since he began to play othello games with other patients and his doctors. Case 2: A 71-year-old right-handed housewife had progressively altered in her personality and behavior over 4 years. She was restless and showed striking palilalia with marked right frontotemporal atrophy when initially evaluated 2 years after her initial symptoms. Subsequently, her verbal output decreased. She ate large amounts of food and her overweight became a serious problem in her care at home. On admission she wandered about the ward irritably, ate meals of other patients, and put on a quilt on their head. However, these troublesome behavior disappeared when she was bent on knitting that was her former hobby. Case 3: A 63-year-old right handed physician presented with a 5-year history of increasing word-finding difficulty and impaired comprehension of nominal terms. His conversation was limited to continuous repetition of a few phrases. He wandered into several hospitals around his house in fixed order every day. On examination, he was mildly disinhibited and distractible with circumscribed bilateral frontotemporal atrophy which was more marked on the left side. Wandering away from home overnight necessitated admission to the hospital. In the ward he wandered about and tried to open each door restlessly and irritably. However, he has become calm and his expression has become peaceful since he was conducted to measure blood pressures of his nurses. Case 4: A 65-year-old right-handed retired office worker.(ABSTRACT TRUNCATED AT 400 WORDS)
匹克病比阿尔茨海默病更常并发行为障碍，如社会行为不检和刻板行为，这些行为令人困扰且临床管理困难。本研究的目的是通过利用匹克病患者可能保留的程序性记忆来探讨改善其护理的可能性。对4名住院患者和2名门诊匹克病患者进行了研究。病例1：一名54岁右利手退休职员，有3年逐渐加重的坐立不安、找词困难和名词理解受损病史。由于其社会行为不检和无法沟通，他被迫退休。入院时，他在病房里烦躁地四处游荡，不与人交谈，还把铅笔插入钥匙孔破坏了病房里所有的钥匙。神经放射学检查显示双侧额颞叶局限性萎缩，左侧更明显。然而，自从他开始与其他患者和医生一起玩黑白棋游戏后，他对病房生活的适应性增强，表情也变得平静。病例2：一名71岁右利手家庭主妇，4年来性格和行为逐渐改变。最初症状出现2年后，即最初评估时，她坐立不安，有明显的重复言语，右侧额颞叶明显萎缩。随后，她的言语输出减少。她大量进食，体重超重成为在家护理中的一个严重问题。入院时，她在病房里烦躁地四处游荡，吃其他患者的饭菜，还把被子盖在他们头上。然而，当她专注于编织（她以前的爱好）时，这些令人烦恼的行为消失了。病例3：一名63岁右利手医生，有5年逐渐加重的找词困难和名词理解受损病史。他的谈话仅限于不断重复几个短语。他每天按固定顺序徘徊在他家周围的几家医院。检查时，他有轻度的行为脱抑制和注意力分散，双侧额颞叶局限性萎缩，左侧更明显。夜间离家出走需要住院治疗。在病房里，他四处游荡，烦躁不安地试图打开每扇门。然而，自从他被安排为护士量血压后，他变得平静，表情也变得平和。病例4：一名65岁右利手退休办公室职员。（摘要截短至400字）
