小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 认知波动
- 幻视
- 运动症状
- 快速眼动期(REM)睡眠行为障碍
其他诊断因素
- 对抗精神病药物高度敏感
- 抑郁症
- 反复跌倒和晕厥
- 体位性低血压
- 尿失禁
- 便秘
- 注意力和视空间觉异常
- 妄想
- 睡眠过度
- 嗅觉减退
- 幻听
危险因素
- 老年
- 男性
- 家族性发病
诊断性检查
首要检查
- 全血细胞计数 (FBC)
- 生化检查
- 血清促甲状腺激素 (TSH)
- 血清维生素 B12
- 血清叶酸
- 血清 VDRL
- 尿液药物筛查
- 尿液分析
- HIV 检测
需考虑的检查
- 头颅 CT
- 颅脑 MRI 扫描
- 定量脑电图 (EEG)
- 脑脊液 (脑脊液) 分析
- 神经心理测验
- 单光子发射断层扫描(SPECT)/正电子发射断层扫描(PET)
- MIBG 心肌显像
治疗流程
行为障碍,尤其是伴或不伴有激越的严重焦虑
无急性行为障碍
撰稿人
作者
Alan J. Lerner, MD
Professor of Neurology
Department of Neurology
University Hospitals Case Medical Center
Case Western Reserve University
Cleveland
OH
利益声明
AJL receives research grant support from NIH, TauRx, Eli Lilly, and Axovant, and has been a medicolegal consultant in several legal cases, but he declares that he has no competing interests related to this topic.
鸣谢
Dr Alan J. Lerner would like to gratefully acknowledge Dr Brian S. Appleby, Dr Ethan Gore, Dr Rajeet Shrestha, Dr Timothy Wuerz, Dr Julie Schneider, Dr Viola Fahmy, and Dr Sube Banerjee, previous contributors to this monograph. BSA, EG, RS, TW, JS, VF, and SB declare that they have no competing interests.
同行评议者
Bryan Bernard, PhD
Assistant Professor and Clinical Neuropsychologist
Department of Neurological Sciences
Rush University Medical Center
Chicago
IL
利益声明
BB declares that he has no competing interests.
James E. Galvin, MD, MPH
Associate Professor
Neurology, Psychiatry and Neurobiology
Director
Memory Diagnostic Center and Alzheimer Treatment Unit
Director
Education and Community Outreach
Alzheimer Disease Research Center
Washington University School of Medicine
St Louis
MO
利益声明
JEG declares that he has no competing interests.
Ian McKeith, MBBS
Professor of Old Age Psychiatry
Clinical Director
Institute for Ageing and Health
Newcastle University
Newcastle
UK
利益声明
IM is the author of several references cited in this topic.
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