藉由完整評估與神經影像學檢查診斷的中年早發病的阿茲海默氏症

Probable Early-onset Alzheimer’s Disease Diagnosed by Comprehensive Evaluation and Neuroimage Studies

目的：本個案報告發表一中年早發病病人，藉由完整評估與影像學檢查後，診斷為阿茲海默氏症。個案報告：病人患有記憶力喪失、執行功能障害與社會職業功能受損的50歲女性，因為她被懷疑是早期發病的失智症，所以安排完整的神經精神醫學評估與神經影像學檢查，包含腦部磁振造影(MRI)與正子檢查(SPECT)。結論：結合臨床病史、神經精神科評估、神經影像檢查如腦部磁振造影與單光子射出電腦斷層掃描，將可診斷中年發病的阿茲海默氏症。雖然50歲前發病的失智症十分罕見，正確的疾病鑑別診斷仍是重要課題之一。神經影像學將扮演此中年發病失智症鑑別診斷的重要角色。

Objective: We present a case of a female patient who was diagnosed with early-onset dementia after we did a comprehensive evaluation. Case Report: This 50-year-old female patient who showed insidious memory impairment, disturbances in executive functioning, and signifi cant impairment in occupational functioning. Under the assumption of early-onset Alzheimer’s dementia (AD) ( <65 years of age), we completed a detailed clinical history and physical examination as well as neuropsychological tests. The patient also received neuropsychiatric evaluation, brain magnetic resonance imaging (MRI), and single photon emission computed tomography (SPECT). Conclusion: Early-onset AD was strongly suggested basing on the fi ndings of the clinical history, neuropsychiatric evaluation, physical examination, as well as brain MRI and brain SPECT studies. Therefore, early-onset dementia, especially in patients younger than 50 years, is rare. Accurate diagnosis of dementia subtypes is challenging. In addition to comprehensive examination, neuroimaging study can provide additional information for differential diagnosis.