目的　探讨老年期发病的海绵状脑病的临床特点并分析误诊原因。　方法　报告 1例79岁老年海绵状脑病的临床病理诊断过程 ,并复习国内报道的经病理学证实的 8例 6 0岁以上老年海绵状脑病患者的临床特征及脑电图、MRI资料。　结果　老年人海绵状脑病急性发病者病程短 ,但都有进行性痴呆、肌阵挛及各种不自主运动发作。 6例脑电图有典型的周期性三相波 ,1例MRI发现双侧基底节区T2 高信号。 3例初诊为脑血管病 ,1例为单疱性脑炎。病理上有典型的空泡和海绵状改变。　结论　急性发病的老年人海绵状脑病容易误诊为脑血管病 ;但根据患者典型的临床表现 ,结合动态脑电图特征 ,必要时行脑活检 ,可尽早诊断 ,减少医源性传播 Objective To investigate the clinical features of spongiform encephalopathy in senile and to analyze the causes of misdiagnosis. Methods The clinical and pathological diagnosis of a 79-year-old man with spongiform encephalopathy was reported. The clinical features, EEG and MRI data of 8 cases of elderly patients with spongiform encephalopathy over the age of 60 years confirmed by pathology were reviewed. Results The elderly patients with acute onset of spongiform encephalopathy had a short course of disease, but all had progressive dementia, myoclonus and various involuntary movements. 6 cases of EEG typical cyclical three-phase wave, one case of MRI found in bilateral basal ganglia T2 high signal. 3 cases of newly diagnosed as cerebrovascular disease, 1 case of unilateral encephalitis. Pathological changes are typical vacuoles and sponges. Conclusions The acute onset of spongiform encephalopathy in the elderly is easily misdiagnosed as cerebrovascular disease. However, according to the typical clinical manifestations of patients and the dynamic EEG features, brain biopsy may be performed if necessary. Early diagnosis and reduction of iatrogenic transmission