维生素B_(12)缺乏引起的快速进展性痴呆、不自主运动1例  

Rapid progressive dementia and involuntary movement caused by vitamin B_(12) deficiency: a case report

作　　者：刘兰兰 蒋欣[2,3] 邢雪韦 帖彦清 齐国松[1] 王晶晶 冯潇潇 吕佩源 LIU Lanlan;JIANG Xin;XING Xuewei;TIE Yanqing;QI Guosong;WANG Jingjing;FENG Xiaoxiao;LYU Peiyuan(Department of Postgraduate of Hebei North University,Zhangjiakou 075000,China;Department of Neurology,Hebei General Hospital;Hebei Provincial Laboratory for Cerebral Networks and Cognitive Disoeders;Hebei Medical University,Shijiazhuang 050017,China;不详)

机构地区：[1]河北北方学院研究生院,张家口075000 [2]河北省人民医院神经内科 [3]河北省脑网络与认知障碍疾病重点实验室 [4]河北省人民医院检验科 [5]河北医科大学研究生院 [6]石家庄市人民医院神经内科

出　　处：《中国神经精神疾病杂志》2024年第3期165-167,共3页Chinese Journal of Nervous and Mental Diseases

基　　金：河北省自然科学基金项目(编号:H2022307075);河北省高端人才支持计划(编号:冀办【2019】63号);河北省科技创新团队(编号:冀政字【2020】9号)。

摘　　要：报告1例41岁男性,以快速进行性加重的记忆力减退2个月,发作性四肢抖动2周为主要表现。查体示言语不利,记忆力、注意力、理解力、定向力均下降。血清维生素B_(12)水平下降,血清抗胃壁细胞抗体、抗内因子抗体阳性,血液分析提示大细胞性贫血,神经心理量表提示多个认知域功能损害,电生理检查提示周围神经损害,脑脊液及影像学检查未见异常。诊断为维生素B_(12)缺乏性痴呆,维生素B_(12)缺乏相关的不自主运动,恶性贫血。给予补充B族维生素及叶酸,认知功能损害明显改善,肢体抖动症状消失。报告本病例旨在提高临床医生对于维生素B_(12)缺乏导致痴呆、不自主运动的认识,以早期诊断及治疗。A 41-year-old male was presented with rapidly progression memory impairment for 2 months and episodic limb shaking for 2 weeks as the main manifestations.Physical examination showed verbal disadvantage with decreased memory,attention,comprehension,and orientation.Serum vitamin B_(12) levels decreased,serum anti gastric parietal cell antibodies and anti-intrinsic factor antibodies were positive.Blood analysis showed macrocytic anemia,neuropsychological scale showed functional impairment in multiple cognitive domains,electrophysiological examination showed peripheral nerve damage,cerebrospinal fluid and imaging examination showed no abnormalities.The patient was diagnosed as having vitamin B_(12) deficiency dementia,vitamin B_(12) deficiency related involuntary movement and pernicious anemia.Supplementing with B vitamins and folic acid significantly improved cognitive impairment and eliminated symptoms of limb shaking.The purpose of this case report is to enhance the understanding of clinical doctors about dementia and involunting movement caused by vitamin B12 deficiency,in order to diagnose and treat it early.

关 键 词：维生素B_(12)缺乏 快速进展性痴呆 不自主运动 恶性贫血 抗内因子抗体 高同型半胱氨酸血症 周围神经损害 

分 类 号：R749.1[医药卫生—神经病学与精神病学]