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Approach to Dementia (History (Loss of >2 Cognitive Function Short…

- - - - Do you have trouble remembering names/ events
      - Do you misplace personal belongings?
    - - Do you have trouble balancing checkbook
    - - Do you get lost in familiar places?
  - - - 1) Analgesics
        2) Anticholinergics
        3) Psychotrophic
        4) Sedative Hypnotics
- - - - Distinguishing Clinical Features
        
        stepwise or pregressive course
        
        vascular risk factors
        
        previous vascular events
        
        focal neurological deficits
        
        CT shows multiple infarctions
    - - Distinguishing Clinical Features
        
        early behavioral abnormalities
        
        obssessive-compulsive features
        
        PET can help distinguish from AD
    - - Distinguishing Clinical Features
        
        associated with Parkinsonism
        
        Psychotic features are common
        
        suspected in a patient with parkinsonism and progressive dementia
    - - Distinguishing Clinical Features
        
        relatively normal neuro exam
        
        language dysfunction
        hippocampal atrophy on MRI
        No lab abnormalities
  - - - Distinguishing Clinical Features
        
        associated with myoclonus
        
        more rapidly progressive than AD
        
        may have corticospinal tract signs
        
        MRI shows abnormalities in basal ganglia
        
        EEG shows periodic discharge
        
        Protein 14-3-3 in CSF
  - - - Distinguishing Clinical Features
        
        triad of dementia, ataxia and urinary incontinence
        
        brain imaging shows ventricular enlargement out of proportion to brain atropy