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題 名 | 臨床表現類似精神分裂症之猝睡症:一例報告=Narcolepsy with Schizophrenic-like Manifestations: A Case Report |
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作 者 | 陳俊興; 李宇宙; 徐崇堯; 蔡政楒; 陳喬琪; | 書刊名 | 臺灣精神醫學 |
卷 期 | 13:2 1999.06[民88.06] |
頁 次 | 頁73-79 |
分類號 | 415.939 |
關鍵詞 | 猝睡症; 精神分裂症; 猝倒; 快速動眼期睡眠; Narcolepsy; Schizophrenia; Cataplexy; REM sleep; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:報告一猝睡症的個案,其臨床表現以明顯的幻覺及妄想症狀為主,易被診 斷為精神分裂症。病例報告:本文報告一位十七歲未婚女性的猝睡症患者,臨床症狀以視幻 覺、聽幻覺及次發性關係妄想為主,最初被診斷為精神分裂症,經兩種抗精神病藥物治療反 應不佳。進一步檢查,發現有白天過度嗜睡、猝倒及睡眠麻痺等症狀。在睡眠腦波、人體白 血球抗原檢查的輔助下,證實為猝睡症,並以中樞神經興奮劑與三環抗鬱劑治療,症狀顯著 改善。結論:某些猝睡症患者,臨床症狀與原發性精神病症狀不易區分。針對此一發現,本 文回顧文獻,一些治療反應不佳的精神分裂症,後來證實為猝睡症的報告,並討論快速動眼 期睡眠與精神症狀的關係。 |
英文摘要 | Objective:We report the case of a narcoleptic patient, whose psyciatric symptoms consisted mainly of hallucinations and delusion of reference, suggestive of schizophrenia. Case Report: This 17 year-old female patient presented with visual hallucinations, auditory hallucinations and secondary delusion, leading to an initial diagnosis of schizophrenia. The hallucinations persisted in spite of treatment with two kinds of antipsychotics. Follow-up examination disclosed excessive daytime sleepiness, cataplexy and sleep paralysis. Multiple sleep latency test showed sleep onset rapid eye movement, and HLA-typing revealed positive HLA-DR15, DQ6. Narcolepsy was diagnosed and psychostimulant and tricyclic antidepressant therapy were administered under the diagnosis of narcolepsy. Her clinical symptoms improved markedly thereafter. Conclusion: Some of the clinical symptoms of narcolepsy, such as hallucinations and secondary delusions, are quite difficult to differentiate from those of schizophrenia. Indeed, some reported cases of treatment-refractory schizophrenia have turnqed out to be narcolepsy. The details of the present case are discussed with an emphasis on the relationship between sleep onset REM and primary mental symptoms. (Full Text in Chinese) |
本系統中英文摘要資訊取自各篇刊載內容。