上海精神医学
上海精神醫學
상해정신의학
SHANGHAI ARCHIVES OF PSYCHIATRY
2015年
1期
52-54
,共3页
狂犬病%精神症状%脑萎缩
狂犬病%精神癥狀%腦萎縮
광견병%정신증상%뇌위축
Rabies%mental symptoms%brain atrophy%China
概述:狂犬病是一种致死率很高的病毒性传染疾病。狂犬病的典型症状包括恐水症、咽肌痉挛和进行性瘫痪。狂犬病所致的持续性精神障碍较为罕见。这里报道一名22岁的男性狂犬病患者。该患者自被病狗咬伤后,没有立即接种狂犬病疫苗,而只是在当地诊所不规范治疗。一周后,患者出现定向障碍、偏执,并表现出攻击性。咬伤后一个月,患者脑脊液中检测到狂犬病病毒抗体,头颅磁共振成像(MRI)显示豆状核、尾状核以及岛叶异常信号影。患者的精神症状持续了6年,生活不能自理,但生命体征平稳,无脑干受损表现。发病6年后再次检查头颅MRI,检查结果为脑萎缩。
概述:狂犬病是一種緻死率很高的病毒性傳染疾病。狂犬病的典型癥狀包括恐水癥、嚥肌痙攣和進行性癱瘓。狂犬病所緻的持續性精神障礙較為罕見。這裏報道一名22歲的男性狂犬病患者。該患者自被病狗咬傷後,沒有立即接種狂犬病疫苗,而隻是在噹地診所不規範治療。一週後,患者齣現定嚮障礙、偏執,併錶現齣攻擊性。咬傷後一箇月,患者腦脊液中檢測到狂犬病病毒抗體,頭顱磁共振成像(MRI)顯示豆狀覈、尾狀覈以及島葉異常信號影。患者的精神癥狀持續瞭6年,生活不能自理,但生命體徵平穩,無腦榦受損錶現。髮病6年後再次檢查頭顱MRI,檢查結果為腦萎縮。
개술:광견병시일충치사솔흔고적병독성전염질병。광견병적전형증상포괄공수증、인기경련화진행성탄탄。광견병소치적지속성정신장애교위한견。저리보도일명22세적남성광견병환자。해환자자피병구교상후,몰유립즉접충광견병역묘,이지시재당지진소불규범치료。일주후,환자출현정향장애、편집,병표현출공격성。교상후일개월,환자뇌척액중검측도광견병병독항체,두로자공진성상(MRI)현시두상핵、미상핵이급도협이상신호영。환자적정신증상지속료6년,생활불능자리,단생명체정평은,무뇌간수손표현。발병6년후재차검사두로MRI,검사결과위뇌위축。
Summary: Rabies is a viral infection with a high case fatality rate. Typical symptoms of rabies include hydrophobia, pharynx muscle spasms, and progressive paralysis. Rabies-induced persistent mental disturbances are rare. Here we report a 22-year-old male who was infected with rabies atfer being attacked by a dog. He did not receive rabies vaccine immediately atfer the incident and was only provided with non-standard treatment at a local clinic. A week later he became disorientated, paranoid, and aggressive. One month after the attack, rabies antibody was found in his cerebrospinal fluid and a Magnetic Resonance Imaging (MRI) examinaiton of his head revealed abnormal signals in the putamina, caudate nucleus, and insula. His mental symptoms persisted for six years and his daily funcitoning was severely impaired, but his vital signs were stable without signs of brain stem damage. Six years atfer the incident, a repeat MRI showed brain atrophy.