Progressive degeneration of the corpus callosum
Introduction
Introduction to carcass progressive degeneration The progressive degeneration of the corpus callosum is called Marchliafara-Bignami disease. It is a rare disease that is complicated by chronic alcoholism. Most of them are middle-aged men. They often coexist with malnutrition and other alcoholic diseases. The lesions mainly invade the middle layer of the corpus callosum. For the adjacent white matter and the cerebellum, the feet can also be affected. No specific treatment, poor prognosis. basic knowledge The proportion of illness: the incidence rate is about 0.005%-0.007% Susceptible people: The disease mainly occurs in middle-aged men who are addicted to various alcoholic beverages and have severe alcoholism. Mode of infection: non-infectious Complications: arrhythmia congestive heart failure cardiomyopathy myocardial infarction hypertension
Cause
Carcass progressive degenerative cause
(1) Causes of the disease
The disease is related to alcoholism, but the pathogenesis of the disease is unknown, mainly invading the middle layer of the corpus callosum, followed by the adjacent white matter of the brain and the midbrain of the cerebellum can also be affected. The radiation and anterior commissure are rare, and the lesion is symmetrical. The sheath was lost, part or the whole carcass was involved, and the fiber in the central part was the heaviest. The lesion was visually observed as a gray softening zone. There were residual gelatinous and blood vessels in the microscopic examination. There was no obvious relationship between the lesion and the blood vessel.
(two) pathogenesis
The pathogenesis of Marchliafara-Bignami disease is unclear. Long-term alcohol abuse is undoubtedly an obvious risk factor. It has been confirmed that a large number of uncontrolled drinking alcohols have great damage to many organs and organs of the body. The nervous system is the main target of alcohol abuse. One of the organs, but this disease is also seen in non-alcoholic people. Experimental cyanide poisoning and carbon monoxide poisoning can cause this disease, so it may be related to ischemia and hypoxia.
Prevention
Carcass progressive degeneration prevention
A small amount of reasonable drinking may have certain benefits for the human body. Avoiding long-term heavy drinking is the main measure to prevent Marchiafara-Bignami disease caused by alcoholism. This disease is also seen in non-alcoholic people. Cyanide poisoning and carbon monoxide poisoning can also cause this disease, so prevention The primary disease is very important.
Complication
Carcass progressive degeneration complications Complications arrhythmia congestive heart failure cardiomyopathy myocardial infarction hypertension
Alcohol abuse has great damage to many organs of the human body. It has been confirmed that alcoholism can cause digestive tract inflammation, liver and kidney dysfunction, severe arrhythmia, congestive heart failure, cardiac wall thrombosis, cardiomyopathy, and myocardium. Infarction, hypertension, and increased platelet count, increased agglutination function and prolonged spontaneous dissolution of fibrin.
Symptom
Carcass progressive degeneration symptoms common symptoms behavior and mood abnormal coma illusion anxiety dementia tremor
1. The disease was first reported by Marchliafara and Bignami (1903). The disease mainly occurred in middle-aged men with severe alcoholism who were addicted to various alcoholic beverages.
2. The clinical manifestations of Marchliafara-Bignami disease are not characteristic, similar to other nervous system damage caused by alcoholism, but patients have many cognitive and behavioral abnormalities, often manifested as anxiety, apathy, hallucinations, mood disorders and behavioral abnormalities. Patients may develop progressive dementia within a few years, and some may be characterized by periodic stupor and coma, and may have tremors, convulsions, delirium and hallucinations. In severe cases, they may stun and die quickly, and some patients may have language problems. Slow movement, rigidity or paralysis, incontinence and so on.
3. Signs may have original sucking reflex, grasping reflex and extensor muscle rigidity, etc. In some cases, CT or MRI may show narrowing of the carcass and localized atrophy.
Examine
Examination of progressive degeneration of the corpus callosum
1. The determination of blood and urine alcohol concentration has the significance of diagnosis and degree of poisoning.
2. Other blood tests include blood biochemistry, liver function, kidney function, coagulation function and immunoglobulin.
3. ECG, EEG, brain CT or MRI examination, there is a differential diagnosis and the significance of the degree of poisoning assessment.
4. Electromyography and neurophysiological examination have differential diagnosis significance.
Diagnosis
Diagnosis and differentiation of carcass progressive degeneration
diagnosis
The diagnosis of this disease is very difficult, such as severe chronic alcoholism patients with the above clinical manifestations, should be suspected of the disease, but rarely diagnosed before death, usually after the death of autopsy confirmed, a small number of cases of CT or MRI can show corpus callosum.
Differential diagnosis
1. Should pay attention to the identification of diseases that cause coma, such as sedative hypnotic poisoning, carbon monoxide poisoning, stroke, craniocerebral trauma and so on.
2. It should also be differentiated from mental illness, epilepsy, asphyxiating gas poisoning, and hypoglycemia.
3. Intelligent barriers and personality changes should be differentiated from dementia caused by other encephalopathy.
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