脑干梗死后大脑脚幻觉伴认知障碍和精神行为异常一例

A case of peduncular hallucinosis accompanied by cognitive impairment as well as psychiatric and behavioral abnormalities after brain stem infarction

大脑脚幻觉主要表现为脑干、丘脑损伤后患者出现的复杂、生动的视幻觉,是一类临床罕见的综合征。该文报道1例脑干梗死后出现大脑脚幻觉伴认知障碍和精神行为异常的患者,在应用氢溴酸西酞普兰治疗后,症状明显改善。结合文献回顾,作者探讨了5-羟色胺能神经环路在孤立性脑干损伤继发大脑脚幻觉伴额叶症候群发病机制中的作用及5-羟色胺能疗法的治疗价值。

Peduncular hallucinosis is a rare clinical syndrome,mainly manifested as complex and vivid hallucinations secondary to brainstem and thalamus lesions.The authors reported a rare case of peduncular hallucinosis accompanied by cognitive impairment as well as psychiatric and behavioral abnormalities after brain stem infarction.After treatment with citalopram hydrobromide,the patient′s symptoms were improved significantly.Based on the case and literature review,the authors discussed the role of 5-hydroxytryptamine circuit in the pathogenesis of peduncular hallucinosis with frontal lobe syndrome secondary to isolated brainstem injury and the potential value of serotonergic therapy.