Caselli R J, Scheithauer B W, O'Duffy J D, Peterson G C, Westmoreland B F, Davenport P A
Department of Neurology, Mayo Clinic Scottsdale, Arizona 85259.
Mayo Clin Proc. 1993 Sep;68(9):846-53. doi: 10.1016/s0025-6196(12)60692-2.
We describe two patients with a chronic encephalopathy that clinically resembled dementia but that resolved after oral administration of high-dose corticosteroid therapy. Both patients had serologically documented Sjögren's syndrome, a diagnosis that was further supported by biopsy of a salivary gland in one. Neither patient had radiologic evidence of vasculitis of the central nervous system. In one patient, meningeal and brain biopsy specimens showed perivascular inflammatory lymphocytic infiltrates. Chronic inflammatory meningoencephalitis is a treatable cause of chronic encephalopathy that should be clinically distinguished from dementia associated with Alzheimer's disease.
我们描述了两名患有慢性脑病的患者,其临床表现类似痴呆,但口服高剂量皮质类固醇治疗后病情缓解。两名患者血清学检查均确诊为干燥综合征,其中一名患者的唾液腺活检进一步支持了这一诊断。两名患者均无中枢神经系统血管炎的影像学证据。在一名患者中,脑膜和脑活检标本显示血管周围炎性淋巴细胞浸润。慢性炎症性脑膜脑炎是慢性脑病的一种可治疗病因,临床上应与阿尔茨海默病相关的痴呆相鉴别。