目的 提高散发性克雅病临床诊断水平,降低其误诊率.方法 回顾性分析11例克雅病患者临床表现及早期误诊情况.结果 11例克雅病患者早期误诊为阿尔茨海默病4例,病毒性脑炎3例,脑梗死2例,路易体痴呆2例,脑脊液14-3-3蛋白阳性6例.结论 克雅病的早期临床表现极不典型,较易误诊;多次复查脑电图、磁共振弥散加权成像、脑脊液14-3-3蛋白是诊断本病的重要手段.%Objective To improve the clinical practical diagnosis of sporadic Creutzfeldt-Jakob disease and decrease the probability of misdiagnosis.Methods Clinical manifestations of 11 cases of Creutzfeldt-Jakob disease misdiagnosed in the early stage were reviewed.Results Eleven cases of Creutzfeldt-Jakob disease were misdiagnosed as Alzheimer' s disease (4 cases), viral encephalitis (3 cases),cerebral infarction (2 cases) and dementia with Lewy bodies (2 cases) in the early stage.Cerebrospinal fluid 14-3-3 protein was positive in 6 cases.Conclusions The clinical manifestations of Creutzfeldt- Jakob disease in the early stage are atypical and tend to be misdiagnosed;repetitive EEG,diffusion weighted imaging and cerebrospinal fluid 14-3-3 protein are essential to diagnosis.
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