Friday, April 27, 2012

Dementias

Xteristic features:

Alzheimers : memory loss first before onset of behavioural changes, confusion, gets lost in familiar neighbourhood , neurofibrillary tangles, enlarged ventricles, (Drug Tmt: Donepezil)

Lewy body : Parkinsonism,  Hallucinations, fluctuations in cognition and alertness

Picks  dx :  behavioural changes more prominent and preceeds memory loss, aphasia, frontotemporal atrophy

Pseudodementia : Depression

Normal pressure hydroceph : urinary incontinence, gait ataxia (large vol LP is both diagnostic and therapeutic)

Creutzfeldt Jacob dx  : prion dx, rapidly progressing dementia, ataxia, myoclonus, gait abnormalities, seizures, memory loss, personality changes, hallucination, sharp triphasic synchronous discharge on EEG. Mostly sporadic.

Huntington : Early onset dementia, Ataxia, Chorea, Family history, Aut Dominant.

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