Dementia (13) Flashcards
Dementia
Progressive, irreversible syndrome characterised by impairment of mental function
Epidemiology
700,000 people affected in UK
Neurodegenerative dementais
Alzheimer’s, Lewy body, Frontotemporal, Huntington’s
Other causes of dementia
Vascular and Prion disease
Vascular dementia
Treatment slows progression, doesn’t cure
Prion disease dementia
Rare, rapid progression and untreatable
Dementia classification subcortical
Apathetic, forgetful, slow, poor ability to use knowledge (PD)
Dementia classification cortical
Dysphasia, agnosia, apraxia (AD)
Dementias (clinical classification)
- Alzheimer’s
- Frontotemporal (behavioural/frontal variant, non-fluent progressive aphasia, semantic dementia)
- Dementia with Lewy bodies
Movement disorders (clinical classification)
- PD
- Parkinson plus syndromes (progressive supra nuclear palsy, multiple system atrophy, corticobasal degeneration)
- Huntington’s disease
- Motor neuron disease
Molecular- genetic classification
- Tauopathies
- Synucleionpathies
- Ubiquinopathies
Tauopathies
- FTD and FTDP - 17
- PSP
- Corticobasal degeneration
- Alzheimer’s
Ubiquinopathies
- MND and dementia
- Semantic dementia
Synucleinopathies
- PD
- Dementia with Lewy Bodies
- MSA
Normal pressure hydrocephalus triad of
- Dementia
- Gait disturbance
- Urinary incontinence
Two types of normal pressure hydrocephalus
- With a preceding cause (SAH, meningitis, trauma, radiation-induced)
- No preceding cause (idiopathic 50%)
Hypoglycaemia
Mycoclonic jerks, EEG slow
CJD/transmissible spongiform encephalopathies symptoms
Mild unsteadiness, primary ataxia, myoclonic jerks
CJD histoloy
Brain looks like sponge
CJD EEG
Triphasic waves
Sporadic CJD MRI
Non-specific changes to basal ganglia
Variant CJD MRI
‘Pulvinar sign’ abnormal posterior thalamic (specific and sensitive)
CBD symptoms
Difficulty writing, speech sparse, bradykinetic, no tremor, mild rigidity, alien limb
CBD electron microscopy
Phosphor-tau filaments within neutron, cytoplasmic tangles, neutrophil threads
VGKC Ab LE
Limbic encephalitis due to voltage gated potassium channel antibody
VGKC Ab LE symptoms
Fits, confused, ‘frontal’ effect, significant cognitive defect, subacute memory less, psychiatric/behaviour disturbances, seizures (partial), hyponatraemia
VGKC Ab LE MRI
MTL high signal
VGKC Ab LE Serum and CSF antibodies
To LGI1 subunit of K channel, others CASPR2
VGKC Ab LE median age
65 2:1 male:female
