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題名 | Frontotemporal Dementia:A Case Study with MRI, SPECT and Neuropsychological Tests=額顳葉失智症:神經心理測驗、磁振造影與單光子放射電腦斷層掃描個案研究 |
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作者 | 白明奇; | 書刊名 | 慈濟醫學 |
卷期 | 10:1 1998.03[民87.03] |
頁次 | 頁69-75 |
分類號 | 415.847 |
關鍵詞 | 額顳葉失智症; Pick氏症; 失智症; 額葉功能; 個性改變; Frontotemporal dementia; MRI; Neuropsychological test; Personality; Single photon emission computed tomography; |
語文 | 英文(English) |
中文摘要 | 額籲葉失智症(frontotcmporal dementia:FID)是近幾年被提出之觀念,源於 部份非阿茲海默氏症之失智患者(demcntia of non-Alzheimer type),其臨床表現以額葉 功能退化為主,結構性與功能性影像檢查以及神經心理測驗也顯示額葉萎縮與功能退化, 然而其病理變化卻沒有Pick氏體,為了與Pick氏症區別,特稱為額葉退化症(frontal lobe degeneration type)。FTD之病理變化則包含了額葉退化症、Pick氏症以及運動神經 元病型。FID於臨床上之特點為大腦功能退化以前額葉功能敗壞為主,例如個性改變,社 會禮儀敗壞,不知變通,而記憶力之退化相較於前述功能退化,則稍晚出現,其發生率遠 低於阿茲海默氏症。 本篇報告一位男性病人從64歲開始發病,以個性改變與行為失去約束力為主要症狀, 漸進惡化,其神經心理學測驗顯示額葉功能障礙,磁振造影與單光子放射斷層掃撤均顯示 額葉出現特別明顯之萎縮與同區域之血流灌注下降。病人於發病4年後達到緘默不語,並 住進安養院,是一個典型之FID病例。 |
英文摘要 | Frontotemporal dementia is the second most common cause, after Alzheimer's disease, of primary cerebral atrophy in the presenium. It occurs more frequently than is wider), thought. I report on a 66-year-old retired businessman who presented with gradual personality, change, accompanied by loss of social and personal awareness. His symptoms had progressed from an insidious onset two years previously. Neuropsychological tests showed deficits mainly in the domain of the frontal lobe function. Visuospatial orientation, praxis, and language abilities were preserved. Single photon emission computed tomography showed anterior cerebral hypoperfusion. Cerebral MRI showed diffuse brain atrophy, especially in the anterior cerebral parts, and an asymmetrical right temporal tissue loss. Cerebral MRI performed 34 months later showed further atrophic change, especially it? the frontal area. His mental status gradually deteriorated, leading to mutism 4 years after the onset. This is a case of frontotemporal dementia. |
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