Definition Features Etiology Diagnosis Differential
Diagnosis
Management
It’s
a chronic organic disorder characterized
by: -impairment of intellectual functions -impairment of memory -deterioration of personality with lack of personal care.
Impairment
of judgment, impulse control & abstract thinking. Emotional labiality Catastrophic reaction Thought abnormalities- delusions & perseveration. Disorientation in time (place & person in late stage) Neurological signs depending on underlying cause.
developed drug TACRINE HYDROCHLORIDE (COGNEX) Ach concentration by slowing its degeneration.
Increases
2nd
commonest cause
Multiple cerebral infarction Progressive disruption of brain function Dementia
Abrupt Acute Step
onset
exacerbation due to repeat infarction
ladder pattern of deterioration course
Fluctuating Presence
of hypertension or other CVS
diseases.
Previous
H/O stroke or TIAs.
On
evaluation: -presence of focal neurological signs -insight in to the illness present -emotional lability present.
o
Treatment of underlying cause prevents further deterioration.
Most
important treatable & reversible cause of dementia. confirmed by lab tests.
Diagnosis Prompt
treatment can reverse dementia & can lead to complete recovery within 2 years of onset of dementia.
50-70%
of AIDS patients exhibit triad of COGNITIVE, BEHAVIOURAL & MOTORIC deficits of SUB CORTICAL DEMENTIA type known as ADC.
AIDS virus – neurotropic features Crosses blood brain barrier early in disease Cognitive impairment
o
Confirmation of disease by: -ELISA -western blot technique
CT scan will show cortical atrophy MRI helpful in detecting white matter lesions.
o
o
According
required: Evidence of decline in both memory & thinking, sufficient to impair personal activities.
Memory
to ICD-10,following features are
impairment typically affects registration, storage & retrieval of new information(recent memory). Remote memory may be intact till late stages.
Thinking Flow
& reasoning capacity impaired
of ideas reduced of clear consciousness of atleast 6 months.
Presence Duration
NORMAL AGING
PROCESS:
-intellectual impairment is severe enough to interfere with social/occupational functioning SENESENT FORGETFULNESS.
urine R/E, blood glucose, electrolytes, RFT, TFT, serum B12 & folate levels, serology for syphilis & HIV, CT & MRI scan of brain, psychological tests & drug screen.
Hypertension
Thyroid
in MID
hormone replacement in hydrocepalus dementia
Shunting L-DOPA
in parkinsonism of toxic agents in toxic causes.
Removal
Environmental Treatment Care
manipulation
of medical complications
of food & personal hygiene care of patient & the family for anxiety(lorazepam &
Supportive
Bezodiazepines
oxazepam)
Depression
can be treated with drugs having low cardiac & anticholinergic toxicity like trazodone. & disruptive behavior with low dose of antipsychotics like haloperidol & trifluperazine. term hospitalization