Schizophrenia or neurodegenerative disease prodrome? Outcome of a first psychotic episode in a 35-year-old woman.
Schizophrenia or neurodegenerative disease prodrome? Outcome of a first psychotic episode in a 35-year-old woman.
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DOI：
10.1016/j.psym.2011.04.005
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发表时间：
2012-05
期刊：
影响因子：
3.4
通讯作者：
Rankin, Katherine P.
中科院分区：
文献类型：
--
作者：
Khan, Baber K.;Woolley, Josh D.;Chao, Steven;See, Tricia;Karydas, Anna M.;Miller, Bruce L.;Rankin, Katherine P.
早发性神经退行性疾病患者可能会出现与精神分裂症重叠的临床综合征，这些患者在精神病环境中接受长期护理而不是接受专门治疗其疾病的神经科医生的更适当护理并不罕见。一名35岁的女性，表现为新发妄想、饮食异常、行为紊乱、缺乏洞察力、抑制解除和刻板运动行为，被诊断为精神分裂症并住院治疗。后来，她被发现有MAPT tau S356T突变和与额颞叶痴呆（FTD）一致的脑萎缩局灶性模式。医生应了解某些形式的FTD和精神分裂症之间症状和发病年龄的潜在重叠，并应将FTD纳入新发、快速进行性人格改变或行为症状（如暴食、高水平社交抑制解除或进行性缄默症）成人患者的诊断鉴别中。
Patients with early onset neurodegenerative disease can present with a clinical syndrome that overlaps with schizophrenia, and it is not uncommon for these patients to undergo long-term care in psychiatric settings rather than receiving more appropriate care by neurologists specializing in their disease. A 35-year old woman who presented with new-onset delusions, eating abnormalities, disorganized behavior, lack of insight, disinhibition, and stereotypical motor behaviors was diagnosed with schizophrenia and institutionalized. Later she was found to have a MAPT tau S356T mutation and a focal pattern of brain atrophy consistent with frontotemporal dementia (FTD). Physicians should be aware of the potential overlap in symptoms and age of onset between some forms of FTD and schizophrenia, and should include FTD in the diagnostic differential for adult patients with new onset, rapidly progressive personality changes or behavioral symptoms such as binge eating, high levels of social disinhibition, or progressive mutism.
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