Subacute cognitive disorders

Question 1

What are some causes of subacute cognitive disorders?

Answer 1

Toxins (Alcohol, CO poisoning)
Neurodegeneration (CJD)
Metabolic (B12 & Ca deficiency, thyroid disorders)
Inflammatory (Limbic, encephalitis)
Mood disorders
Functional cognitive impairment
Infection (E.g. syphilis, HIV)

Question 2

What is Creutzfeld-Jakob disease (CJD)?

Answer 2

A rare, rapidly worsening brain disorder that causes unique changes in brain tissue and affects muscle coordination thinking, and memory.

Question 3

What causes CJD?

Answer 3

Abnormal prion protein causes misfiling of normal prion proteins into abnormal prion proteins causing neurodegeneration

Question 4

What are the 4 main aetiological classes of CJD?

Answer 4

Sporadic - >60 years
varient - Patients 20 years due to BSE
Iatrogenic - Patients 30 years
Genetic - Any age

Question 5

How does CJD present?

Answer 5

Myoclonus
Visual disturbances
Cerebellar, pyramidal and extrapyramidal signs Rapidly progressive cognitive and functional impairment

Question 6

How is CJD managed?

Answer 6

Supportive treatment

Question 7

What is functional cognitive impairment?

Answer 7

A problem with memory or concentration that happens when the brain doesn’t work or function as we need it to

Functional cognitive symptoms are not caused by disease or damage to the brain, but they are coming from the brain.

Question 8

What are some factors that can interrupt attention?

Answer 8

• Physical symptoms
• Pain
• Sleep problems
• Stress
• Experience of a stressful event or injury
• Medication
• “Software errors” - getting stuck in an involuntary thinking loop

Question 9

What causes functional cognitive symptoms?

Answer 9

Most things that cause functional cognitive symptoms do so by interfering with a set of brain processes called attention

Attention is like a spotlight and a filter, directing the brains processing capacity towards important information and filtering out irrelevant information

Question 10

What is a common cause of functional cognitive disorder?

Answer 10

Head injury (E.g. concussion)

Question 11

What are some functional cognitive symptoms?

Answer 11

• Losing track whilst doing things
• Going blank
• mental fuzziness, sluggishness or mental fatigue
• Losing track during conversations
• Forgetting periods of time (On autopilot)
• Forgetting a word that seems to be on the tip of your tongue

Question 12

What are some management options in FCD?

Answer 12

• Manage worsening factors
• Reassurnace
• Keep in mind that memory lapses are normal
• Possible CBT