中英105JAMA尸检克雅氏病CJD

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A51-year-oldmanpresentedwithprogressivedifficultywalkingthatdevelopedover1monthshortlyafterheranamarathon.Hefrequentlyfellandhaddifficultyclimbingthestairs.Hestatedhehadhearingproblems,butwithfurtherquestioning,itwasdiscoveredheactuallyhaddifficultydecipheringspeech.Hedidnothavedizzinessonstandingnorbowelorbladderincontinence.Hedidnottakemedications,andhedranksocially.Hehadnofamilyhistoryofimbalanceproblems.Hestillworkedfull-timeasalawyer.

51岁男性患者1月前参加完马拉松比赛后出现进行行走困难，经常感觉到爬楼困难，并自觉有听力障碍，进一步询问病史可发现其有语言发音难以辨认的问题。病人无头晕，无大小便失禁。否认服药史，社交场合偶有饮酒。无平衡功能障碍家族史，职业是全职律师。

Hisneurologicalexaminationshowedmildcerebellarataxiawithoutmyoclonusorparkinsonism.HisMontrealCognitiveAssessmentscorewas28of30points(2pointsdeductedfrom“delayedrecall”).Puretoneaudiometryshowednoconductiveorsensorineuralhearingloss.Brainmagneticresonanceimaging(MRI)revealednoabnormalsignal,includingfromtheponsandcerebellum.A







































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