以认知障碍和喉鸣为突出表现的多系统萎缩的诊断与鉴别诊断

Diagnosis and differential diagnosis of multiple system atrophy with the outstanding systoms of cognitive impairment and throat singing

目的通过对多系统萎缩(MSA)少见症状的认识,提高对该病的诊断水平。方法对一例临床诊断的MSA进行详细病例分析并文献复习。结果患者男性,71岁,以认知障碍、喉鸣为突出表现,迅速进展的运动障碍合并自主神经功能损害。头MRI显示脑萎缩,脑桥基底出现十字征改变。结论 MSA是涉及神经系统多个部位的变性萎缩,进展迅速,需要认识喉鸣这种少见症状。认知功能损害并不少见,早期出现喉鸣、球麻痹提示预后不良。

Objective To improve the level of diagnosis, based on the understanding of the unusual symptoms of multiple system atrophy （MSA）. Methods We analyzed the clinical characteristics of a case of MSA and reviewed the relevant literature. Results The patient was a 71 year old male, with cognitive impairment, throat singing for outstanding symptoms, rapid progress to movement disorders and vegetal nerve dys- function. Conclusion MSA involved in multiple parts of the nervous system, The neurology physician should know the unusual symptom of throat singing. Cognitive impairment is not uncommon. Early throat singing, pseudobulbar palsy may implicate poor outcome.