Treatable dementias

Question 1

Treatable dementias (treatable causes of dementia) can be classified by referring to the underlying pathologies. The nature of these pathologies can be metabolic, structural, infective autoimmune, epileptic or of other controversial entities.

Name a metabolic pathology which can underlie treatable dementias.

Answer 1

Any from:
- Vitamin deficiencies (such as B12/folate)
- Thyroid dysfunction
- Metabolic encephalopathies (renal/hepatic)
- Toxic encephalopathies

Question 2

Treatable dementias (treatable causes of dementia) can be classified by referring to the underlying pathologies. The nature of these pathologies can be metabolic, structural, infective autoimmune, epileptic or of other controversial entities.

Name a structural pathology which can underlie treatable dementias.

Answer 2

Any from:
- Hydrocephalus (raised pressure in the brain)
- Tumours (e.g. frontal meningioma can present as frontotemporal dementia (FTD))

Question 3

Treatable dementias (treatable causes of dementia) can be classified by referring to the underlying pathologies. The nature of these pathologies can be metabolic, structural, infective autoimmune, epileptic or of other controversial entities.

Name an infective pathology which can underlie treatable dementias.

Answer 3

Any from:
- HIV
- Syphilis

Question 4

Treatable dementias (treatable causes of dementia) can be classified by referring to the underlying pathologies. The nature of these pathologies can be metabolic, structural, infective autoimmune, epileptic or of other controversial entities.

Name an autoimmune pathology which can underlie treatable dementias.

Answer 4

Any from:
- Encephalitis
- Vasculitis

Question 5

Treatable dementias (treatable causes of dementia) can be classified by referring to the underlying pathologies. The nature of these pathologies can be metabolic, structural, infective autoimmune, epileptic or of other controversial entities.

Name an epileptic pathology which can underlie treatable dementias.

Answer 5

Transient epileptic amnesia (TEA) can present similarly to Alzheimer’s disease.

Question 6

Treatable dementias (treatable causes of dementia) can be classified by referring to the underlying pathologies. The nature of these pathologies can be metabolic, structural, infective autoimmune, epileptic or of other controversial entities.

Name a controversial entity which can underlie treatable dementias.

Answer 6

Any from:
- Normal pressure hydrocephalus
- Hashimoto’s encephalopathy

Question 7

What tests/procedures comprise the screening process for reversible causes of dementia?

Answer 7

Bloods and MRI brain scan

Question 8

As part of the screening process for reversible (treatable) causes of dementia, what needs to be tested for in blood tests?

Answer 8

Any from and including:
- B12/folate (methylmalonic acid - one of the products in the pathway if B12 is low)
- Thyroid function
- ESR - a marker of generalised inflammation or illness
- Syphilis/HIV serology
- ammonia (liver disease) , If patients tend to drink a lot
- Toxins (if history of exposure) , e.g. if someone worked in a mercury factory, test for possible high levels of mercury

Question 9

As part of the screening process for reversible (treatable) causes of dementia, what needs to be tested for in an MRI brain scan?

Answer 9

Any structural abnormalities need to be identified (other than and not including atrophy). No atrophy is a sign that there is likely something other than dementia going on.