3例少见痴呆症病例报告.docVIP

3例少见痴呆症病例报告 　　（1. 上海中医药大学附属龙华医院神经内科 上海 200032；2. 上海中医医院急诊科 上海 200071） 　　摘 要 目的：总结桥本脑病、额颞叶痴呆症和麻痹性痴呆症的临床表现，为临床医生诊断这些少见类型的痴呆症提供帮助。方法：分析经临床及相关实验室检查确诊的3例少见类型痴呆症病例的有关临床资料。结果：桥本脑病以局灶性神经功能缺损或精神异常伴有血清抗甲状腺过氧化物酶抗体、脑脊液中蛋白质水平异常为主要特点；额颞叶痴呆症以人格改变、情感变化和举止不当为临床表现，影像学上以额颞叶萎缩为主要特点；麻痹性痴呆症以精神异常起病、进行性智能减退为主要表现，需详细询问个人冶游史、服药史等，阿-罗瞳孔、血清快速血浆反应素试验、血清梅素螺旋体明胶凝集试验以及头颅磁共振成像检查均有助于诊断。结论：对记忆力减退患者需关注相关的伴随症状以及症状出现的先后顺序，详细询问其个人冶游史、服药史等，完善相关实验室检查。 　　关键词 桥本脑病 额颞叶痴呆症 麻痹性痴呆症 　　中图分类号：R749.1 文献标识码：C 文章编号：1006-1533（2014）17-0001-04 　　Report for 3 rare dementia cases* 　　Gu Chao1**， Shen Ting2， Yuan Canxing1， An Hongmei1， Zhang Tianli1 　　（1. Department of Neurology， Longhua Hospital， Shanghai University of TCM， Shanghai 200032， China； 　　2. Department of Emergency， Shanghai Municipal Hospital of Traditional Chinese Medicine， Shanghai 200071， China） 　　Abstract Objective： To summarize the clinical characteristics of Hashimoto’s encephalopathy， front temporal dementia， general paresis of the insane， to help doctors diagnose these rare types of dementia. Methods： Clinical data on 3 patients with rare types of dementia confirmed by clinical and related laboratory were analyzed. Results： Hashimoto’s encephalopathy is characterized as manifestations of focal neurological deficits or psychological problem with anti-thyroperoxidase antibody， cerebrospinal fluid protein abnormalities， front temporal dementia as personality changes， emotional changes and misbehavior， iconography as dementia in front and temporal， and general paresis of the insane as psychological problem and progressive intelligence. It is important for doctors to ask for some information about personal histories such as history of prostitution， history of medication. Argyll-Robertson pupil， rapid plasma reagin test， Treponema pallidum particle assay of serum and cerebrospinal fluid， head MRI are helpful in the diagnosis of this disease. Conclusion： It’s necessary to pay close attention to its accompanying symptoms and the orders of symptom oc