麻痹性痴呆12例误诊原因分析

目的：分析麻痹性痴呆（GPI）误诊原因。方法：回顾性分析12例麻痹性痴呆患者的临床资料，智能检测和各项实验室检查结果。结果：12例患者曾误诊为精神分裂症4例，躁狂发作3例，老年性痴呆3例，多发性硬化和病毒性脑炎各1例。所有患者梅毒螺旋体血液检查及脑脊液检查均为阳性，简易智力状态量表评分均≤20分。经大剂量青霉素治疗后，一般精神症状控制，智力部分恢复，神经体征残留。结论：麻痹性痴呆极易被误诊，忽略了患者的认知障碍和未做细致的神经系统检查是误诊的重要原因。早期诊断和治疗是预后的关键。

An analysis of misdiagnosed causes on 12 cases with general paresis of insane

Objective： To analyze the misdiagnosed causes of patients with general paresis of insane （GPI） . Method：Clinical data of 12 cases with GIP were retrospectively analyzed including intelligence scale and laboratory tests. Results ： Among 12 cases, 4 were given wrong diagnosis of schizophrenia, 3 of manic episode ,3 of Alzheimer disease, 1 of multiple sclerosis and 1 of virus encephalopathy . The blood tests for syphilis of all patients were positive as well as from the cerebrospinal fluid . The scores of intelligence scale were ≤20. After treatment by antispirochete, clinical symptoms were controlled, and intelligence was recovered partially, but neurotic signs were remained. Conclusion： GPI is very easily misdiagnosed . Because of neglecting cognitive disorders and nerve system examination. Early finding and intervention might be the key for prognosis.