Memory Disorders Flashcards
memory loss
in between state of normal aging and dementia
Independence and ADLs preserved
balance checkbook
Mild cognitive impairment
reversible causes of dementia
hypothyroidism, Vit B1 B12 def, depression, normal pressure hydrocephalus, subdural hematoma, chronic infection, brain tumor, medications
progressive disorder in: recent episodic memory, language, visuospatial function, executive function
ADLs lost
Alzheimer’s Disease
Alzheimer’s Disease Imaging on CT or MRI
variable amounts of cortical and hippocampal atrophy
prominent atrophy in parietal and temporal lobes
Alzheimer’s Tx
AChEIs ( donepezil, rivastigmine, galantamine)
Gluatmate Receptor Modulators (memantine/Namenda)
SSRI (depression)
sudden, variable symptoms (focal weakness, apathy, falls, frontal/executive cognitive slowing)
stepwise cognative decline
Risk factors for vascular disease
Localizing deficits: anosagnosia & prosopagnosia
Vascular Dementia
infarct to right parietal area
denies deficit
anosagnosia
bilateral or right mesial occipitotemporal lesions
does not recognize familiar face
prosopagnosia
Vascular Dementia MRI
cortical and subcortical infarctions
confluent white matter disease
Vascular Dementia Tx
prevent further stroke
manage risk factors
treat psychiatric symptoms
fatal prion disease- spongiform encephalopathy (spongiform degen of neurons) familiar, sporadic, iatrogenic forms rapidly progressive dementia startle myoclonus and ataxia prodromal sympt: malaise, fatigue, increased sleep and eating disturbances 90% mortality CSF + for 14-3-3 protein
CJD (creutzfeld-jacob disease)
CJD (creutzfeld-jacob disease)
none
CJD (creutzfeld-jacob disease) MRI
increased signal intensity in putamen and caudate
Fluctuating cognition/LOC
visual hallucinations, parkinsonian motor signs
REM sleep behavior disorder
Capgras syndrome
attentional, frontal-executive and visuospatial deficits
Diffuse Lewy body dementia
delusion that familiar person has been replaced by imposter
Capgras syndrome
Diffuse Lewy body dementia PET scan
occipital lobe hypometabolism
Diffuse Lewy body dementia patho
lewy bodies in limbic, paralimbic, and neocortical regions
Diffuse Lewy body dementia Tx
difficult- sensitive to drugs
Levodopa–> psychosis
antipsycs-> contraindicated
(atypicals: quetiepine & clozapine)
neurodegenerative
insidious onset: deterioration in attention & concentration/ memory, dizziness, headaches
lack of insight, poor judgment, overt dementia
parkinsonian with masked facies and tremor
contact sports or military blast injuries
all cases have been exposed to repetitive brain trauma
“dementia puglistica/punch drunk”
chronic traumatic encephalopathy
chronic traumatic encephalopathy patho
extensive neurofibrillary tangles, progressive tauopathy
APOE4 homozygote status predispose
CAN: global confusion, ataxia, opthalmoplegia progresses into Korsakoff's psychosis(memory loss and confabulation) lesions in dorsomedial nuclei of thalamus--> amnesia severe thiamine (vit B1( def alcoholics/malnurished
Wernicke’s encephalopathy
Wernicke’s encephalopathy tx
admin IV thiamine prior to glucose admin
Wet, wobbly, wacky: incontinence, gait diff, memory loss
Ct: enlarged ventricles
potentially reversible memory loss & parkinsonism
Normal pressure hydrocephalus
Normal pressure hydrocephalus tx
Lumbar puncture performed
tx with venticuloperitoneal shunt
apathy, reduced judgment, insight/speech/language, hyperorality, excessive compulsions
-behavioral variant/frontal variant
-primary progressive aphasia
-semantic dementia
earlier onset (50s-60s)
initial: changes in personality & socially inappropriate behavior
Frontotemporal dementia
Frontotemporal dementia association and tx
associated with ALS
ACHEi worsen behavioral symptoms
psychomotor slowing and memory impairment
hung up reflexes
hypothyroidism
work up for memory loss
exclude reversible causes blood work: thyroid, B12, thiamine, CBC, BMP imaging: MRI (&ct) EEG depression screening
