Corticobasal degeneration with visual hallucination as an initial symptom: A case report.

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Neuropathology Pub Date : 2024-08-01 Epub Date: 2024-01-30 DOI:10.1111/neup.12963
Kentaro Yoshida, Tadashi Adachi, Yuki Suzuki, Mayuko Sakuwa, Hiroki Fukuda, Masato Hasegawa, Yoshiki Adachi, Hiroshi Miura, Ritsuko Hanajima
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Abstract

Although the initial symptoms of corticobasal degeneration (CBD) are varied, psychiatric symptoms are uncommon. Here, we report the autopsy findings of a patient with early CBD who presented with hallucinations. A 68-year-old man developed memory loss and visions of bears and insects. Because of slow vertical eye movement, postural instability, and levodopa-unresponsive parkinsonism, the patient initially was clinically diagnosed with progressive supranuclear palsy. He died of a urinary tract infection 11 months after the onset of the disease. Histopathological examination revealed neuronal loss and gliosis, which were severe in the substantia nigra and moderate in the globus pallidus and subthalamic nucleus. Astrocytic plaques were scattered throughout the amygdala and premotor cortex. The superficial cortical layers lacked ballooned neurons and spongiosis, and tau deposition was greater in glia than in neurons. The amygdala contained a moderate number of argyrophilic grains and pretangles. Western blot analysis showed a 37-kDa band among the low-molecular-weight tau fragments. Because the CBD pathology was mild, we attributed the patient's visual hallucinations to the marked argyrophilic grain pathology. CBD can occur with psychiatric symptoms, including visual hallucinations, and argyrophilic grain pathology may be associated with psychiatric symptoms.

以视幻觉为首发症状的皮质基底层变性:病例报告。
虽然皮质基底层变性(CBD)的初期症状多种多样,但精神症状并不常见。在此,我们报告了一名出现幻觉的早期CBD患者的尸检结果。一名 68 岁的男子出现记忆力减退,并幻觉到熊和昆虫。由于患者的眼球垂直运动缓慢、姿势不稳和左旋多巴无反应性帕金森病,临床上最初诊断为进行性核上性麻痹。发病 11 个月后,他死于尿路感染。组织病理学检查显示,黑质神经元缺失和胶质增生严重,球状苍白球和丘脑下核中度缺失和胶质增生。星形胶质细胞斑块散布在杏仁核和前运动皮层。皮质浅层缺乏气球状神经元和海绵状血管增生,胶质细胞中的tau沉积多于神经元。杏仁核中含有一定数量的嗜杏仁颗粒和前角质层。Western 印迹分析显示,低分子量 tau 片段中有一条 37 kDa 的条带。由于CBD病变较轻,我们将患者的视幻觉归因于明显的霰粒细胞病变。CBD可伴有包括视幻觉在内的精神症状,而嗜碱性颗粒病理可能与精神症状有关。
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来源期刊
Neuropathology
Neuropathology 医学-病理学
CiteScore
4.10
自引率
4.30%
发文量
105
审稿时长
6-12 weeks
期刊介绍: Neuropathology is an international journal sponsored by the Japanese Society of Neuropathology and publishes peer-reviewed original papers dealing with all aspects of human and experimental neuropathology and related fields of research. The Journal aims to promote the international exchange of results and encourages authors from all countries to submit papers in the following categories: Original Articles, Case Reports, Short Communications, Occasional Reviews, Editorials and Letters to the Editor. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.
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