目的 分析Creutzfeldt-Jakob病的误诊原因,提出防范误诊对策.方法 回顾性分析3例Creutzfeldt-Jakob病的诊治过程.结果 3例分别以言语紊乱、反应迟钝、头晕、步态不稳等就诊,病初误诊为老年痴呆、缺血性脑血管病、颈椎病、多发腔隙性脑梗死.入我院后完善脑电图、3T头颅MRI增强扫描等检查,明确诊断为Creutzfeldt-Jakob病.结论 Creutzfeldt-Jakob病早期症状极不典型,进行性痴呆、肌阵挛等是其典型临床表现,三相波为该病典型脑电图表现,脑电图、3T头颅MRI增强扫描有助诊断.%Objective To analyze the cause of misdiagnosis of sporadic Creutzfeldt-Jakob disease (sCJD) and provide strategies to prevent misdiagnosis. Methods The clinical data of 3 patients with sCJD were retrospectively analyzed. Results The patients were admitted to our hospital for lalopathy, slow reaction, dizziness and unsteady walking, and were misdiagnosed as having Alzheimer's disease, ischemic cerebrovascular disease,cervical spondylosis, and multiple lacunar infarction, respectively. After examination of electroencephalogram (EEG) and the enhancement scanning of 3T MRI, all the patients were diagnosed as having CJD. Conclusion The clinical characteristics of sCJD were atypical early symptom, progressive dementia and myoclonus. The three-phase wave usually appears on EEG, and EEG and the enhancement scanning of 3T MRI may contribute to diagnosis.
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