一例克罗伊茨费尔特-雅各布病的临床与脑电图分析

Clinical syndrome and electroencephalography in one patient with Creutzfeldt-Jakob disease

目的探讨克罗伊茨费尔特-雅各布病(CJD)的临床及脑电图表现特征。方法回顾分析1例CJD患者的临床表现与脑电图特征并结合文献复习。结果 CJD患者以双眼视力进行性下降、四肢震颤伴意识不清为首发症状。脑电图呈阵发周期现象,周期波以高幅尖波、慢波、三相波或多相波为主要特征,且这种脑电图的异常程度随患者病情加重而持续加重。头颅MRI可见右侧顶枕叶皮层缺血性改变,双侧额、顶叶皮层下及双侧放射冠、基底节区等多发脑缺血或者腔隙性脑梗死及软化灶,存在一定程度的脑萎缩。结论以高幅尖波、慢波、三相波或多相波为主要特征的阵发周期脑电图可作为CJD的重要诊断依据。

Objective To study the clinical and EEG characteristics of sporadic Creutzfeldt-Jakob disease （CJD）. Methods To analyze the clinical manifestation and EEG character of one case with CJD and review its litera- ture review. Results The initial and prominent symptoms showed the progressive declination in binocular vision and limbs tremor accompanying with unconsciousness. The typical EEG exhibited the paroxysmal periodic waves in- cluding high amplitude spike-wave, slow wave, three phases and multiple waves, which became more serious along with the worse state of illness. The Brain MR/showed the ischemic changes in right parietal occipital cortex, the multi- ple cerebral isehemia, lacunar infarction and malacia in bilateral frontal and parietal cortex, bilateral corona radiata, and the basal ganglia. Also the brain atrophy was found by MRI. Conclusion The characteristic EEG with high am- plitude slow wave, three phases and multiple waves can be considered as the important index to diagnose CJD.