临床荟萃

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典型克雅氏病2例并文献回顾

  

  1. 河北医科大学第二医院 神经内科,河北 石家庄 050000
  • 出版日期:2017-04-05 发布日期:2017-03-31
  • 通讯作者: 通信作者:王惠娟,Email:hjwangdor@163.com

Creutzfeldt-Jacob disease--two cases and literature review

  1. Department of Neurology,the Second Hospital of Hebei Medical University, Shijiazhuang 050000,China
  • Online:2017-04-05 Published:2017-03-31
  • Contact: Corresponding author: Wang Huijuan,Email:hjwangdor@163.com

摘要: 目的探讨克雅氏病(CreutzfeldtJacob disease,CJD)的发病机制,病因分型,临床表现,脑脊液的特点,核磁共振成像表现,脑电图改变及诊断标准。方法对本院收治的2例CJD患者的临床资料进行分析。结果CJD临床特征为进行性痴呆、共济失调、肌阵挛。脑电图的周期性尖-慢复合波,核磁共振皮层异常高信号(缎带征)以及脑脊液中的1433蛋白均支持该病的诊断。结论CJD在脑电图、核磁共振及脑脊液中具有典型的特征。尤其是核磁共振的弥散成像,作为一种无创的检测手段具有较高的敏感度和特异度。

关键词: 脊髓疾病, 痴呆, 磁共振成像, 脑电描记术, 脑脊液

Abstract: ObjectiveTo explore the pathogenesis,etiological subtype,clinical manifestation,cerebrospinal fluid (CSF) characters,magnetic resonance imaging(MRI) findings,electroencephalogram (EEG)  changes and diagnosis criteria of CreutzfeldtJacob disease(CJD).MethodsAnalysis was made in the clinical data of two CJD patients from the hospital. ResultsCJD showed the clinical manifestation predominantly of progressive dementia,ataxia and myoclonus. Occurrence of periodic sharp wave complexes(PSWCs) in EEG, hyper intense signal changes in cortical regions (cortical ribboning)  in MRI, and protein 1433 in CFS substantiate all supported the diagnosis. ConclusionCJD has typical characters of EEG,MRI and CFS. Specially, diffusion weighted imaging may be a noninvasive screening tool with higher sensitivity and specificity.

Key words: spinal cord disease, dementia, magnetic resonance imaging, electroencephalography, cerebrospinal fluid