PDF(Pubmed)
Abstract：
Ammonia is considered to be a neurotoxin that affects various physiological pathways, including energy metabolism, mitochondria function, and inflammatory response. Dysfunctions of these pathways contribute to the development of cognitive and executive function impairments. A case of a 67-year-old female patient who presented with unusual features of delirium after spine surgery was reported in this study. The patient initially developed acute hepatitis, and 3 weeks later, liver functions gradually improved. However, the acute onset of cognitive impairment and mild hyperammonemia was found. The patient mainly presented with cognitive deficits and impairment of executive functions without a fluctuating course. Her cognitive impairment was resolved when the serum ammonia level returned to the normal range. Consequently, we considered the diagnosis for this patient was delirium rather than a major neurocognitive disorder (dementia). Thus, the clinical diagnosis for delirium and etiologies are discussed.
摘要：
氨被认为是一种影响各种生理途径的神经毒素，包括能量代谢，线粒体功能，和炎症反应。这些途径的功能障碍有助于认知和执行功能障碍的发展。本研究报告了一例67岁的女性患者，该患者在脊柱手术后表现出谵妄的异常特征。患者最初发展为急性肝炎，3周后,肝功能逐渐好转。然而,发现了认知障碍和轻度高氨血症的急性发作。患者主要表现为认知障碍和执行功能受损，而病程无波动。当血清氨水平恢复到正常范围时，她的认知障碍得到解决。因此,我们认为该患者的诊断是谵妄,而不是主要的神经认知障碍(痴呆).因此，讨论了谵妄的临床诊断和病因。
