晚发与非晚发精神分裂症临床对照分析

对４年精神病院较近期入院，初次发病年龄在４５岁以上的晚发性精神分裂症患者共２２８例进行观察，以同期住院的４５岁以下，初次发病的精神分裂患者３０９例为对照，结果发现，晚发组文化程度较低，发病前有精神或射体因素为诱因者较多见，以急性或亚急性起病较多，早期症状以神经症样症状较多见，而人格改变较少见，临床类型以偏执型为多，近期疗效较好。临床症状中有不少项目两组患者也有显著差别，除发病年龄两组间又存在这些显     

晚发与早发性精神分裂症的临床对照研究

目的 了解晚发与早发必 之间的差异。方法 我晚发性精神分裂症患者、１０４例早发性精神分裂症患者及３０名正常对照者进行了临床对照研究。结果 晚发组在受教育、婚姻及就业上好于早发组;在诱因和家族史上与早发组无显著差异;临床类型以偏执型多见;精神症状以亡想为主,主要是被害亡想,思维障碍,情感淡漠较少;ＨＡＭＤ分高,提示晚发组常伴情绪低落;ＳＤＳＳ分高,提示社会功能损害晚发组轻于早发组。结论 晚发性精神分     

晚发与早发精神分裂症临床症状的比较研究

目的 了解晚发与早发精神分裂症临床症状之间的差异。方法 对不同年龄初发精神分裂症患者进行BPRS、SANS、SAPS、HAMA和HAMD量表评定,然后作临床症状的比较。结果 晚发组在BPRS缺乏活力因子分,SANS总分,HAMD迟缓、绝望感因子分低于早发组,BPRS敌对猜疑因子分高于早发组(P<0.05)。晚发组的以被害妄想、牵连观念、情绪不稳较多见,而被洞悉感、思维形式障碍、情感迟钝、意志缺乏较少。结论 晚发精神分裂症与早发精神分裂症的临床症状有所不同,提示晚发精神分裂症可以作为精神分裂症的一个亚型。     

早发和晚发性精神分裂症的临床对照分析

本文对１００例早发和晚发性精神分裂症进行临床比较，发现晚发组女性多，起病急，有精神因素，被害妄想、抑郁和类神经症症状较早发组多见；早发组病初表现性格改变，以逻辑障碍、情感淡漠、意志减退多见。在家族史、病前性格及幻听、思维散漫、Ｓｃｈｎｅｉｄｅｒ一级症状等方面二组无显著性差异，治疗近期疗效相似。     

晚发性和早发性精神分裂症的遗传差异

目的：了解晚发性和早发性精神分裂症在遗传效应上的差异。方法：调查精神分裂症晚发组和早发组患者亲属中精神病的患病情况。结果：早发组有精神病家族史多,一级亲属中精神分裂症的发病风险率高,一级亲属的遗传率高,与晚发组比较,有明显的差异性。结论：晚发性和早发性精神分裂症间有遗传效应上的差异。     

女性晚发性精神分裂症50例临床分析

为分析女性晚发性精神分裂症的临床特征,对45岁以后首次发病的女性患,符合CCMD-2-R精神分裂症诊断标准50例,对其临床资料进行回顾性分析。结果女性晚发性精神分裂症绝大多数化程度较低,以急性或亚急性起病较多,偏执型多见,躯体症状明显,多伴焦虑抑郁、自杀意念,小剂量单一用药为主,近期疗效好。     

晚发性精神分裂症的磁共振对照研究

目的：了解晚发生性精神分裂症患者脑共振的变化特征。方法：选择１７例晚发性精神分裂症病人,和正常对照组１７例检测脑的磁共振,以第三脑室宽距,侧脑室间距,侧脑室体部最大间距、左、右颞角宽度,额叶脑兆宽度及顶叶脑沟宽度为观察点。结果：发现病例组异常率为５２．９４％,海马异常诲为４１．１８％,与正常对照组相比,第三脑室、左颞角宽度、额叶脑沟宽度和顶叶脑沟宽度有显著差异。结论：晚发性精神分裂症病人的海马、左     

304例早发与晚发性精神分裂症临床对照分析

目的探讨早发与晚发性精神分裂症的临床不同点。方法对150例早发性精神分裂症和154例晚发性精神分裂症患者的临床资料进行回顾性对照分析。结果两组比较,在部分精神症状如易激惹、妄想、自笑、懒散、脱衣露体、怪异动作、伤人、毁物、出走等,以及性别、病程、文化程度、分型等项上存在显著性差异(P<0.01~0.001)。结论早发性精神分裂症精神症状显著多于晚发性精神分裂症;而晚发性精神分裂症则具有女性多见、文化程度较低、病程较长、妄想多见、偏执型居多等特点。     

阿立哌唑与利培酮治疗晚发精神分裂症对照研究

目的:比较阿立哌唑与利培酮治疗晚发精神分裂症患者的临床疗效和安全性。方法:对52例晚发精神分裂症住院患者随机分为两组,分别用阿立哌唑和利培酮治疗6周。采用阳性与阴性症状量表(PANSS)评定疗效,用治疗中出现的症状量表(TESS)评定不良反应。结果:阿立哌唑与利培酮治疗晚发精神分裂症患者的临床疗效差异无显著性。两组不良反应少而轻。结论:阿立哌唑治疗晚发精神分裂症疗效好,起效快,不良反应少。     

83例晚发性和早发性躁狂症对照研究

回顾性研究了３８例晚发性躁狂症和４５例早发性躁狂症病人的临床特点。结果显示：与早发躁狂症相比，晚发躁狂症病人知音破坏，假性痴呆，荒谬妄想，记忆障碍较多，而情感高涨，性兴趣及阳性家族史明显较少，病前多有社会心理因素及躯体疾病，药物副反应明显。     

晚发性精神分裂症的研究进展

精神分裂症是一种常见的病因尚未完全阐明的精神病,常有特殊的思维、知觉、情感和行为等多方面的障碍和精神活动与环境的不协调。多起病于青壮年,而临床上起病年龄为40岁以上的精神分裂症患者并不少见。Bleuler于1943年首次提出“晚发性精神分裂症”（Late—onset Schizophrenia）,指出发病年龄在40岁以后的为晚发性精神分裂症。     

Relapsed and late-onset Nipah encephalitis

An outbreak of infection with the Nipah virus, a novel paramyxovirus, occurred among pig farmers between September 1998 and June 1999 in Malaysia, involving 265 patients with 105 fatalities. This is a follow-up study 24 months after the outbreak. Twelve survivors (7.5%) of acute encephalitis had recurrent neurological disease (relapsed encephalitis). Of those who initially had acute nonencephalitic or asymptomatic infection, 10 patients (3.4%) had late-onset encephalitis. The mean interval between the first neurological episode and the time of initial infection was 8.4 months. Three patients had a second neurological episode. The onset of the relapsed or late-onset encephalitis was usually acute. Common clinical features were fever, headache, seizures, and focal neurological signs. Four of the 22 relapsed and late-onset encephalitis patients (18%) died. Magnetic resonance imaging typically showed patchy areas of confluent cortical lesions. Serial single-photon emission computed tomography showed the evolution of focal hyperperfusion to hypoperfusion in the corresponding areas. Necropsy of 2 patients showed changes of focal encephalitis with positive immunolocalization for Nipah virus antigens but no evidence of perivenous demyelination. We concluded that a unique relapsing and remitting encephalitis or late-onset encephalitis may result as a complication of persistent Nipah virus infection in the central nervous system.     

A case of late-onset chorea

Background A 75-year-old woman with rheumatoid arthritis presented with a 4-year history of chorea to a hospital movement disorder clinic. The involuntary movements were initially mild, affecting only the right side of the body, but gradually worsened and became bilateral. There was no relevant family history. Medications included hormone replacement therapy (HRT), diclofenac sodium, vitamin D, folic acid, methotrexate and zopiclone. On examination, bilateral choreiform movements were seen, affecting the face and limbs, with the right side more severely affected than the left. Investigations Neuropsychological testing, laboratory blood and DNA testing, echocardiogram, MRI of the brain, and brain perfusion single-photon emission computed tomography (SPECT) scanning.Diagnosis HRT-related chorea, possibly caused by a predisposition secondary to rheumatoid arthritis and small-vessel ischemic disease, or subclinical childhood rheumatic fever. Management Discontinuation of HRT.     

Characteristics of late-onset myasthenia gravis

An increasing incidence of myasthenia gravis (MG) has been reported in the elderly, but the full clinical ramifications of late-onset myasthenia gravis (LOMG) remain unclear. We describe the clinical features of our cohort of patients with MG with an emphasis on an onset after the age of 50. This was a retrospective analysis of medical records of a cohort of patients followed in two tertiary neuromuscular clinics and comparison of early onset MG (EOMG) versus LOMG. There were 174 patients with a mean age of onset of 55.2?±?19.1?years, and 44 % were women. Late onset of myasthenia gravis after age 50 was reported in 114 patients (66 %). Anti-AChR antibody titers were elevated in 78 % of patients (65 % with EOMG vs. 85 % with LOMG; p?=?0.003), and frequency of elevated titers of anti-MuSK antibodies was similar in both groups (present in 38 % of all tested seronegative patients). Myasthenic crisis was equally common in generalized EOMG and LOMG (13 %). Ocular MG was more common in LOMG compared to EOMG (40 vs. 18 %, p?=?0.021). Diabetes was more prevalent with LOMG (27 vs. 5 %; p?=?0.0002). Overlapping clinical features of EOMG and LOMG are consistent with a continuous clinical spectrum of a single condition, with more frequent occurrence of seropositive and ocular MG with a late onset. A higher burden of comorbidities, such as diabetes mellitus, may warrant a modified approach to treatment of myasthenia in LOMG. However, overall disease severity may not be higher with aging. These observations have implications for design of MG clinical trials and outcomes studies.     

Clinical presentation of late-onset schizophrenia

DSM-III-R defines late-onset schizophrenia as schizophrenia that begins after age 45. The authors describe five patients who met DSM-III-R criteria for this disorder. The characteristic features of the disorder include bizarre delusions (usually of a persecutory nature), auditory hallucinations, a history of normal functioning at least until age 45, and a deterioration in personal-social functioning after the onset of illness. Physical examination, routine laboratory tests, neuropsychological evaluation, and magnetic resonance imaging (MRI) scans did not suggest the presence of any diagnosable organic mental disorder. In each of the five cases, mood disorders, delusional (paranoid) disorder, and schizophrenia with onset before age 45 were also considered in the differential diagnosis and ruled out. The authors' case vignettes support the premise that late-onset schizophrenia is a clinically diagnosable entity. Cautions in the diagnosis and treatment of such patients are discussed.     

Quantitative electroencephalography in late-onset schizophrenia

BACKGROUND AND OBJECTIVES: A variety of electroencephalogram (EEG) abnormalities may occur in schizophrenics who had a typical onset of the disorder in early adulthood. The purpose of this study was to investigate EEG findings in patients with late-onset schizophrenia (onset of illness between ages 40 and 60). METHODS: Ten patients (one male, nine female, average age 52.8 years old) with late-onset schizophrenia underwent magnetic resonance imaging (MRI) of the brain and recording of quantitative EEG. RESULTS: MRI results for seven of the subjects were within normal limits and the other three showed nonspecific changes. Quantitative analysis of EEG variables revealed that for eight of the subjects, absolute power and relative power for the four EEG frequency bands, overall mean frequency, mean frequency for each of the EEG frequency bands, and interhemispheric coherence values did not vary significantly from a normative database of age-matched normal subjects. CONCLUSIONS: Results obtained to some degree replicate the single previous EEG study of late-onset schizophrenia. These findings suggest that the neurophysiological etiology and mechanism of late-onset schizophrenia may differ from that of schizophrenia with a typical age of onset, and that brain abnormalities are not an inevitable accompaniment to late onset of schizophrenia.     

Gabapentin in late-onset poststroke seizures

Stroke is a frequent cause of epileptic seizures (ES) in adults. The authors evaluated the long-term efficacy and tolerability of gabapentin (900 to 1,800 mg/day) in 71 patients with a first poststroke late ES during a mean follow-up time of 30 months. ES recurred in 18.3% of the patients and side effects were noted in 27 cases (38%), but only two (2.8%) required discontinuation or early withdrawal. Gabapentin monotherapy was useful and safe for late poststroke ES.