L11: PD, NPH, CJD, Memory Disorders Flashcards
Epidemeology of Parkinson Disease
About 50% of patients have dementia by 85 years old
CP of Parkinson Disease
CP of Parkinson Disease
- Symptoms
Cause of Normal Pressure Hydrocephalus
Derangement of CS hydrodynamics
CP o Normal Pressure Hydrocephalus
INVx for Normal Pressure Hydrocephalus
CT shows ventricular enlargement with no evidence of cortical atrophy
Management of Normal Pressure Hydrocephalus
- Therapeutic Lumbar Puncture
- Ventriculoperitoneal shunt
Management of Normal Pressure Hydrocephalus
- Therapeutic Lumbar Puncture
Most important test
- Remove large amount of CSF.
- Examine gait and cognitive function.
Management of Normal Pressure Hydrocephalus
- Ventriculoperitoneal Shunt
may correct if:
- Patients improve within minutes to hours of removal of 30:40 mL of CSF.
- Trauma or subarachnoid hemorrhage
Age of Cruetzfeldt Jakob Syndrome
40- 75 years
CP of Cruetzfeldt Jakob Syndrome
CP of Cruetzfeldt Jakob Syndrome
- Myoclonus
90% has Myoclonus vs 10% in AD.
CP of Cruetzfeldt Jakob Syndrome
- Dementia
Progressive dementia & personality changes over weeks to months
Prognosis of CJD
Death <1 year from first symptom
INVx for CP of Cruetzfeldt Jakob Syndrome
- EEG: Diffuse slowing and periodic sharp waves or spikes
- MRI: Basal ganglia abnormalities
- CSF: Detect specific amino acid sequence (PrPSc)
Compare between delirium, Dementia & Depression
Def of Pseudo-Dementia
Abrupt onset of Severe depression + Memory & language intact
Symptoms of Pseudo-Dementia
Vegetative symptoms:
1. Insomnia
2. Anergy
3. Loss of Appetite
Examples of Amnestic Disorders
- Aging
- Transient Global Amnesia
- Head injury
- Korsakoff Syndrome
Examples of Amnestic Disorders
- Aging
Examples of Amnestic Disorders
- Transient Global Amnesia
Age of Transient Global Amnesia
Affects patients >50 years.
Frequency of Transient Global Amnesia
Usually have only 1 episode, lasting 6 to 12 hrs.
DDx of Transient Global Amnesia
- psychogenic amnesia
- fugue state
- partial complex status epilepticus.
CP of Transient Global Amnesia
Cause of Transient Global Amnesia
- May be due to vascular insufficiency to hippocampus or midline thalamic projections
Examples of Amnestic Disorders
- Head Injury
CP of Head Injury
- Amnesia
Retrograde amnesia › antegrade amnesia
CP of Head Injury
- With time, memories usually return but rarely to recall events surrounding trauma
Examples of Amestic Disorders
- Korsakoff
CP of Korsakoff’s Syndrome
- Memory
- Near-total inability to establish new memory.
- Immediate memory NL, attention NL
CP of Korsakoff’s Syndrome
- Confabulation
Patients confabulate about recent events.
Initial Evaluation of Dementia
…
Korsakoff’s Syndrome
- Most Common Cause
thiamine and other nutritional deficiencies with chronic alcoholism
