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題 名 | 全身性紅斑性狼瘡合併精神病及癲癇發性--一例報告=Systemic Lupus Erythematosus Associated with Psychosis and Seizure-Report of One Case |
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作 者 | 何志仁; 孫藝文; 陳天令; | 書刊名 | 中華民國風濕病雜誌 |
卷 期 | 14:1/2 民86.05 |
頁 次 | 頁53-62 |
分類號 | 415.695 |
關鍵詞 | 全身性紅斑性狼瘡; 精神病; 癲癇發作; 中樞神經系統侵犯; Systemic lupus erythematosus; Psychosis; Seizure; Central nervous system involvement; |
語 文 | 中文(Chinese) |
中文摘要 | 全身性紅斑性狼瘡(簡稱SLE)患者併有神經精神症狀在臨床上並非罕見,但是有許多不同的致病因素皆可能導致出現神經精神症狀,而其處理方式也有相當大的差異,因此在下SLE併有中樞神經侵犯的診斷時,必須要先排除其他的可能性才可。 本文報告一女性個案,在兩次因SLE住院接受類固醇治療時皆出現精神病,並有一次複雜性局部性癲癇發作。在排除中風、感染、代謝異常等因素後,初步認定為可能是類固醇引起的精神病,因而減少類類固醇劑量,並給予抗精神病劑,但並未使其精神狀況改善,反而更加惡化。經給予高劑量類固醇後,精神病症狀隨著SLE病情的好轉而消失,因此確定為是SLE併有中樞神經侵犯。本文並回顧文獻討論SLE併發精神病症狀之可能致病因素、鑑別診斷、治療及預後。 |
英文摘要 | Neuropychiatric symptoms are not uncommon in patients with SLE. As many causes many lead to psychosis in SLE patients and their treatments also vary, the diagnosis of SLE with central nervous system involvement can be made only when other possible two episodes of psychosis when she was receiving steroid for treatment of SLE in causese are exchuded. Here we have a famale who expexienced two admissions; besides, an episode of complex partial seizure occurred in the first admission. After excluding the possibility of stroke, infections, metabolic abnormalities, etc., we assumed steroid-induced psychosis to be the cause. The dosage of steroid was reduced and at the same time an antipsychotic agent was given. However, the response was even more unfavorable. The diagnosis was changed into SLE with central nervous system involvement. High dosage of steroid was applied, and the patient's symptoms of psychosis thus remitted along with the improvement of SLE. So the suspected diagnosis was finally confirmed. This paper also discusses some possible pathogenses, differential diagnoses, treatments, and prognoses of this manifestation of SLE in detail with relevant literature reviewed. |
本系統中英文摘要資訊取自各篇刊載內容。