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额颞叶痴呆

最后审阅: 10 Nov 2024
最后更新: 08 Nov 2022

小结

定义

病史和体格检查

关键诊断因素

  • 性格、社会行为与习惯粗化
  • 言语流畅性或理解能力进行性丧失
  • 记忆损伤、定向障碍及失用症的产生
  • 进行性自我忽视及抛弃工作、活动与社会接触
完整详情

其他诊断因素

  • 发病年龄早
  • FTD 家族史
  • 进食习惯改变
  • 注意迟钝、幼稚的专注之事、努力不足、冲动反应及强迫行为
  • ALS体征
  • 震颤麻痹症状
  • 肌束颤动、萎缩、反射亢进及运动神经元疾病的其他体征
  • 眉间、鼻、吮吸、觅食或抓握反射
  • 膀胱及肠道控制功能丧失
完整详情

危险因素

  • MAPT基因突变
  • GRN 基因突变
  • C9orf72 基因突变
  • 外伤性脑损伤
完整详情

诊断性检查

首要检查

  • 正式认知测试
  • 脑部 MRI
  • 头颅 CT
  • 全血细胞计数 (FBC)
  • 血清 CRP
  • 血清促甲状腺激素 (TSH)
  • 游离甲状腺素(T4)
  • 生化检查
  • 血清尿素
  • 血清肌酐
  • 肝功能检查 (LFT)
  • 血清维生素 B12 水平
  • 血清叶酸水平
  • 梅毒血清学检查
  • HIV 检测
  • 血清酶联免疫吸附测定
完整详情

需考虑的检查

  • 脑 18F-脱氧葡萄糖 (FDG) PET
  • 脑部单光子发射型计算机断层显像(SPECT)
  • 脑活组织检查
  • 基因检测
  • 结缔组织成套检查
  • 血清红细胞沉降率
完整详情

新兴检查

  • 脑脊液分析

治疗流程

持续性治疗

所有患者

撰稿人

作者

Raghava Kurup Radhakrishnan, DPM(NIMHANS), DNB(Psych), MRCPsych

Consultant Psycho-geriatrician

Waitemata District Health Board

Auckland

New Zealand

利益声明

RKR declares that he has no competing interests.

Sachin Jauhari, DMH, MRCPsych, FRANZCP

Consultant Psycho-geriatrician

Waitemata District Health Board

Honorary Senior Lecturer in Old Age Psychiatry

University of Auckland

Auckland

New Zealand

利益声明

SJ declares that he has no competing interests.

鸣谢

Dr Raghava Kurup Radhakrishnan and Dr Sachin Jauhari would like to gratefully acknowledge Dr Lawrence Whalley and Dr Chiadi Onyike, the previous contributors to this topic, and colleagues Dr Ann Boston (clinical psychologist), Dr Zara Godinovich (clinical psychologist), and Diane Ellis (clinical nurse specialist) for their suggestions.

利益声明

LW, CO, AB, ZG, and DE declare that they have no competing interests.

同行评议者

Daniel Kaufer, MD

Director

Memory Disorders Program

Department of Neurology

University of North Carolina at Chapel Hill

NC

利益声明

DK has received research support, speaking honoraria, and consulting fees from Eisai, Forest Laboratories, Johnson & Johnson, Medivation, Novartis, Ortho-McNeil, and Pfizer.

Bruce L. Miller, MD

Professor of Neurology

University of California

San Francisco

CA

利益声明

BLM declares that he has no competing interests.

Philip Scheltens, MD, PhD

Professor of Neurology

Department of Neurology/Alzheimer Center

VU University Medical Center

Amsterdam

The Netherlands

利益声明

PS declares that he has no competing interests.

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