疑似克-雅病误诊分析  

The analysis of misdiagnosis in suspected Creutzfeldt-Jakob disease

作　　者：赵节绪[1] 林世和[1] 江新梅[1] 宋晓南[1] 

机构地区：[1]吉林大学第一医院神经内科,长春130021

出　　处：《现代神经疾病杂志》2003年第6期355-358,共4页

摘　　要：目的提高对克-雅病的认识及诊断水平。方法对近几年6例疑诊为克-雅病患者的临床表现、辅助检查及最后诊断进行总结和分析。结果6例患者中男4例,女2例,发病年龄为20～56岁。首发症状为精神症状2例,认知障碍1例,肢体活动无力1例,抽搐1例,头晕1例。头部MRI表现异常4例;脑电图异常5例,1例未查;脑脊液异常1例。6例患者经对症治疗,病情均有缓解,可除外克-雅病的诊断。结论克-雅病可以不同症状起病,但快速进展的痴呆、症状的不可逆性、药物治疗无好转是诊断的重要依据。Objective To improve the understanding and diagnostic level for Creutzfeldt-Jakob dis-ease(CJD).Method s The clinical manifestation,laboratory findings and final diagnosis of six patients with suspected CJD were analyzed and reviewed.Results Six patients with tentative diagnosis of CJD(4male and2female)whose onset ages were20to56years.The onset symptoms were mental symptom(n=2),cogni-tive dysfunction(n=1),weakness of extremeties(n=1),convulsion(n=1),dizziness(n=1).Of these patients ab-normal signals in MRI (n=4),in EEG(n=5),in CSF(n=1).Slow waves in EEG5cases,increase of amount of cell in CSF in1case.Symptoms were improved in all6cases after expectant treatment and the diagnosis of CJD could be ruled out.Con clu sion The onset CJD may present with different symptoms ,but the rapid progressed dementia,irreversible symptoms,no effect on treatment with drugs are the important basis for diag-nosis of this disease.[

关 键 词：克-雅病 误诊 慢性一氧化碳中毒后脑病 Lafora型肌阵挛癫痫 震颤性谵妄 单纯疱疹性脑炎 

分 类 号：R741[医药卫生—神经病学与精神病学]