伴皮层绸带征快速进展性阿尔茨海默病1例报告

A case report of rapidly Alzheimer's disease with cortical ribbon sign and literature review

阿尔茨海默病(Alzheimer's Disease,AD)是一种逐渐进展的神经变性疾病,其临床上主要表现为记忆力衰退,同时伴有失认、执行功能障碍以及人格和行为改变等痴呆表现,因此也被称为老年性痴呆。通常AD隐匿发病,病程约10年,但也有少数患者表现为快速进展性AD(rapidly progressive Alzheimer's Disease,rpAD)。AD的头颅磁共振特征是以海马为主的额颖顶叶皮层萎缩,并可伴有脑白质变性和微出血。本文报告1例伴皮层绸带征快速进展性阿尔茨海默病病例,回顾了该病例的发病过程、临床表现、既往史、痴呆家族史、神经系统查体、头颅MRI、脑电图、脑脊液阿尔茨海默病标志物、血清和脑脊液自身免疫性脑炎标志物、血清和脑脊液副肿瘤标志物检测等,并对该病例的诊断过程进行了讨论。

Alzheimer's Disease(AD)is a progressive neurodegenerative disorder,clmically characterized by memory loss,accompanied by misrecognition,executive dysfunction,and personality and behavioral changes,so it is also known as senile dementia.Usually AD is a chronic progressive disease with a course of about 10 years,but a few patients show rapidly progressive AD(rpAD).The characters of AD magnetic resonance image are the atrophies mainly in hippocampus and in frontal,temporal-parietal cortex,and accompanied by cerebral white matter degeneration and microhemorrhage.This paper reports a case of rpAD with cortical ribbon signs,and reviews its medical history,clinical manifestations,previous medical histories,family history of dementia,neurological physical examination,cranial MRI,EEG,cerebrospinal fluid AD markers,serum and cerebrospinal fluid markers of autoimmune encephalitis and paraneoplastic neurologival syndrome,and at last discusses the diagnostic process of this case.