Saturday, November 14, 2009

DEMENTIA SYNDROMES...Clues to differentiate

Thank you all for your patience in awaiting this next blog.


The boards love DEMENTIA related topics and questions, so let's cover the

most important ones. Subtle "clues" will have you select the correct

answer....and that is my aim. Remember, the CAPITALIZED words are

the KEY....but you should already know that from the previous blogs!?



Q: What is the MOST prominent feature of ALZHEIMER'S DEMENTIA?


A: Memory impairment of RECENT events.

The MMSE(Mini Mental Status Exam) score is usually 12-24 the first
5 years, then significantly worsens.



Q: What is DEMENTIA with LEWY BODIES?


A: Most prominent clinical feature is VISUAL HALLUCINATIONS.
Other features are disturbed REM sleep with VIVID DREAMS.
The MMSE score is usually 15-28 the first 5 years.


Q: What is FRONTOTEMPORAL DEMENTIA?


A Key clinical feature is APATHY, with a remarkably NORMAL MMSE score of 30!!!



Q: What is VASCULAR DEMENTIA?


A; As the name implies, the problem is vascular with MRI of BRAIN documenting
at least one INFARCT. The more infarcts...the more evident the diagnosis.



Q: What is NORMAL PRESSURE HYDROCEPHALUS (NPH)?


A: It is a TRIAD of SYMPTOMS in elderly patients:

1. DEMENTIA
2. GAIT IMPAIRMENT ("MAGNETIC GAIT"). Think Frankenstein!!!
3. URINARY INCONTINENCE

The CT/MRI in these patients will show enlarged ventricles and normal
CSF pressure, if measured.



Thanks again for your patience....the next blog will be coming soon.

Look forward to some quite interesting topics and cases.

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