[Cognitive impairment? Don't forget neurolues].

Q4 Medicine
Axel Wolsink, J A Smaal, Edo M Hoogerwaard
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引用次数: 0

Abstract

Background: Cognitive disorders usually develop slowly over years and are mainly caused by untreatable neurodegenerative disorders. Rapidly progressive cognitive disorders should raise suspicion of an underlying and treatable psychiatric, internal or neurological condition. Timely recognition of these conditions is important.

Case: We present the case of a 68-year old man, presenting on the emergency department with a history of progressive cognitive impairment since several weeks. Cerebral MRI showed T2-hyperintensities in the left hippocampal, mesotemporal and insular regions; lesser so in the right mesotemporal region. After initial treatment for herpesencephalitis and autoimmune encephalitis, we diagnosed neurolues and started treatment with benzylpenicillin.

Conclusion: It may be difficult to diagnose neurolues because the vast variety of clinical symptoms and radiological signs. This case shows that neurolues should be considered in a patient with rapidly progressive cognitive disorders and that neurolues can mimic a herpesencephalitis or an autoimmune encephalitis. Timely recognition is important to prevent irreversible damage.

[认知障碍? 别忘了神经lues]。
背景:认知障碍通常在数年内缓慢发展,主要由无法治疗的神经退行性疾病引起。快速进展的认知障碍应怀疑潜在的、可治疗的精神、内脏或神经系统疾病。及时发现这些疾病非常重要:本病例为一名 68 岁的男性,因数周前开始出现进行性认知障碍而到急诊科就诊。大脑磁共振成像显示左侧海马区、中颞区和岛叶区 T2 过度强化,右侧中颞区较轻。在对疱疹性脑炎和自身免疫性脑炎进行初步治疗后,我们诊断为神经性流脑,并开始使用苄青霉素进行治疗:结论:由于临床症状和影像学表现多种多样,诊断神经路可能比较困难。本病例表明,对于认知障碍进展迅速的患者,应考虑神经性流脑,而且神经性流脑可能与疱疹性脑炎或自身免疫性脑炎相似。及时识别对于防止不可逆转的损害非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Nederlands tijdschrift voor geneeskunde
Nederlands tijdschrift voor geneeskunde Medicine-Medicine (all)
CiteScore
0.30
自引率
0.00%
发文量
302
期刊介绍: Het NTVG staat bekend als hét wetenschappelijke algemene medische tijdschrift. De lange historie en de degelijkheid maken het tijdschrift tot een bolwerk van medische wetenschap in druk. Ook door de goede leesbaarheid draagt het tijdschrift bij aan de voortdurende dialoog over de geneeskunde.
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