Study on clinical features in general paresis of insane, HIV ⁃ associated dementia and Creutzfeldt ⁃ Jakob disease behaved as dementia

Abstract

Objective To investigate the clinical features of general paresis of insane (GPI), HIV⁃associated dementia (HAD) and Creutzfeldt ⁃ Jakob disease (CJD). Methods The clinical features, laboratory examination, electroencephalography (EEG), magnetic resonance imaging (MRI), treatment and prognosis of 19 patients (GPI, n = 8; HAD, n = 6; CJD, n = 5) were analyzed retrospectively. Results The cases of three groups had cognitive impairment. At the same time, multiple systems (pyramidal system, extrapyramidal system and cerebellar) and multiple cranial nerves were involved. In GPI patients, the results of rapid plasma regain circle card test (RPR) and treponema pallidum particle agglutination assay (TPPA) were all positive in 8 cases, venereal disease research laboratory tests (VDRL) of CSF were positive in 4 cases, and Head MRI showed encephalatrophy in 6 cases. In HAD patients, serologic tests for HIV of all cases were positive, the average protein of CSF was increased significantly and Pandy's test was positive in 2 cases, Head MRI were characterized with multiple space occupying lesions or diffuse abnormal density image. In CJD patients, CSF 14⁃3⁃3 protein showed positive in 4 patients, EEG showed diffuse slow waves in 5 case, in which 1 case showed typical periodic triphasic wave, Head MRI in 3 sporadic CJD patients (sCJD) showed swelling like changes in sulus of cortex area and 1 varaint CJD (vCJD) patient showed hockey like change in thalamencephalon. Conclusion The clinical characteristics of dementia caused by GPI, HAD or CJD are varied, and the diagnosis mainly depends on clinical features, positive findings in serum, CSF, EEG and MRI detections. DOI：10.3969/j.issn.1672⁃6731.2012.03.019