一例罕见的快速进展性痴呆--克雷菲尔特-雅各布病:病例报告

Maftahul Jannat, Md Shahidullah, S. Dey, SK Mahbub Alam, Abdullah Al Muzahid
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引用次数: 0

摘要

背景:克雅氏病是一种罕见且通常致命的神经退行性疾病,其特征是快速进行性痴呆,并伴有锥体、锥体外锥体、小脑、视觉和行为异常等神经精神表现。在这里,我们报告一例临床可能的克雅氏病在一个55岁的服务人员女士表现为快速进展性痴呆。目的:报告一例罕见的由克雅氏病引起的快速进展性痴呆。方法:对该病例进行充分的临床评估,结合脑电图特征性全身性周期性放电、脑MRI FLAIR及DWI高信号,以及快速进行性痴呆、强直、肌阵挛、不动性失语、行为异常等临床特征,做出可能的诊断。其他痴呆原因被排除在外。结果:最终按照CDC诊断标准对克雅氏病进行可能诊断。由于我国缺乏新的调查和患者监护人拒绝尸检,该病例无法得到证实。结论:虽然罕见,但在伴有复杂神经系统表现的快速进展性痴呆患者中应考虑克雅氏病的怀疑。该病临床表现多变,罕见,常延误诊断。这种疾病总是致命的,迄今为止没有公认的治疗方法。因此,如果早期和准确的诊断是可能的,那么预后和管理计划可以适当地向护理人员解释。孟加拉国医疗理事会2023年公报;49: 190 - 194
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A rare case of rapidly progressive dementia- Creutfeldt Jakob disease: Case report
Background: Creutzfeldt Jakob disease is a rare and usually fatal neurodegenerative disorder characterized by rapidly progressive dementia with other neuropsychiatric manifestations like pyramidal, extrapyramidal, cerebellar, visual and behavioral abnormalities. Here we report a case of clinically probable Creutzfeldt Jakob disease in a 55 years old service holder lady presented with rapidly progressive dementia.   Objective: The aim was to report a rare case of rapidly progressive dementia caused by Creutzfeldt Jakob disease. Methods: The case was thoroughly evaluated clinically then probable diagnosis was made by characteristic generalized periodic discharges on EEG and cortical and basal ganglia hyperintensity on FLAIR and DWI sequences of MRI of brain in addition to the clinical features of rapidly progressive dementia, rigidity, myoclonus, akinetic mutism and behavioral abnormalities. Other causes of dementia were excluded. Result: Finally probable diagnosis of Creutzfeldt Jakob disease was done according to CDC diagnostic criteria. The case could not be confirmed due to lack of available newer investigations in our country and refusal of autopsy by the patient’s guardian. Conclusion: Though rare, a suspicion of Creutzfeldt Jakob disease should be considered in patients with rapidly progressive dementia with complex neurological manifestations. Variable clinical presentation and rarity of the disease always delay the diagnosis. The disease is always fatal and no accepted treatment is available till date. So if early and accurate diagnosis is possible then the prognosis and plan of management could be explained to the caregiver properly. Bangladesh Med Res Counc Bull 2023; 49: 190-194
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0.30
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48
期刊介绍: The official publication of the Bangladesh Medical Research Council.
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