Main outcome measures a marked improvement of mental functions was observed after shunt operation. Her past medical history included neck fracture following a fall 2 years before, from which she recovered fully. Traditional causes of reversible dementias structural brain lesions. A patient with a huge prolactinoma who came to medical attention because of dementia is described. These are especially common in the elderly, as the more medications one takes, the more likely it is that there will be negative interactions that could cause dementia. Reversible dementia, international journal of geriatric. Dementia is a decline or cognitive impairment with memory, verbal skills, recognition, and executive functioning. The possibility of revealing a reversible cause is higher and the differential diagnosis and workup are broadened. Reversible dementia and the misdiagnosis of dementia. Reversible dementia due to coexisting disease the lancet. Etiologies of dementia treatment referral why do we care about dementia. Dementia treatment includes therapy for reversible or curable dementias and nonspecific interventions that may improve the condition of patients with progressive dementia syndromes. This case exemplifies these adverse effects of vpa which can cause reversible neurological symptoms even in longterm treated patients and can present as dementia syndromes such as normal pressure hydrocephalus.
Potentially reversible dementias should be identified and treatment considered, even if the symptoms are not sufficiently severe to meet the clinical criteria for dementia, and even if partial or full reversal of. Its neccessary for proper neurological function and the formation of red blood cells. Although dementia predominated in the clinical picture, the diagnosis was confirmed by computer tomography ct and cerebrospinal fluid infusion test and cisternography. Reversible dementia in systemic lupus erythematosus without. Barthel index was 100 and she was independent until 3 months previously, when she had a global worsening of her mental state.
Once thought to be a normal aspect of the aging process, the dementias are now perceived to be diseases caused by a variety of etiologies, a. Doorways to discovery a reversible form of dementia. Reversible dementia and gait disturbance with valproic acid, hydrocephalus during natalizumab treatment and development of communicating hydrocephalus after infliximab infusion are similar recent reports. Clinicians should have a clinical suspicion about the possibilities of reversible dementia. Jul 15, 2008 a 63yearold woman presented with progressive dementia over 2 years. Longitudinal outcomes of patients with pseudodementia. An 89yearold woman was admitted to the acute geriatric unit of a university hospital in january, 1998, because of subacute cognitive deterioration. This allows the subtyping of dementia that is important for prognosis and. Subfrontal tumors are an infrequent cause of dementia. Textbook of clinical neuropsychiatry second edition david p moore md associate clinical professor, department of psychiatry, associate. It is important that the clinician should be familiar with this rare presentation as the dementia is reversible in most. The prevalence of reversible dementia in a psychiatric hospital. The inservices are appropriate for all staff working.
We recommend blood tests in all patients, to detect not only metabolic causes of dementia but also comorbidity possibly worsening the dementia. Mean dementia severity as assessed on the cdr scale did not however vary significantly between the groups. Case report reversible dementia and gait disturbance after prolonged use of valproic acid matthew d. We have had experience with another parathyroidrelated partially reversible form of dementia. Pdf on jan 1, 2014, manish modi and others published reversible dementia find, read and cite all the research you need.
Reversible dementias journal of neurology, neurosurgery. Pdf reversible dementia in elderly patients referred to a memory. In this communication we describe an interesting case of multiple ncc in an elderly presenting only with dementia and responded well to steroid and cerebral decongestant. Laboratory evaluation of dementia test intended diagnosis use comments psychometric testing all dementias, especially mci, ftd in appropriate clinical context virtually required for mci, mild ad, and ftd. Initial evaluation of the patient with suspected dementia. Irreversible and reversible dementia there are many different dementia typesalzheimers disease, lewy body dementia, vascular dementia. Jun 10, 2000 f formiga and colleagues april 1, p 11541 report on reversible dementia in a woman aged 89 years who was diagnosed as having normalpressure hydrocephalus and hypercalcaemia, which was a result of primary hyperparathyroidism. Its easier to keep them straight if you think about dementia thats reversible and dementia that isnt. Vitamin b12 deficiencies can cause reversible dementia. Download one zipped files that contains the 29 page powerpoint presentation in pdf format, handout of 6 slides per page, a handout, and pretest.
Primary care evaluation of dementia 1 dementia evaluation and treatment jhfdikmdjohn frederick md modified by stephen thielke md dementia evaluation assessment cognitive screeningcognitive screening tests etiologies of dementia treatment referral. Reversible dementia is a type of dementia where it is often a side effect or a symptom of the underlying disease. These changes are often small to start with, but for someone with dementia they have become severe enough to affect daily life. Does reversible dementia exist and is it reversible. Pdf reversible dementia in elderly patients referred to. Reversible dementia in elderly patients referred to a memory. Download pdf view ejournal order reprints get permission. Dementia evaluation and treatment dementia evaluation.
Alzheimers disease and non alzheimers dementias brendan kelley, md associate professor clinical department of neurology the ohio state university wexner medical center dementia a descriptive term, not a disease practical definitionpractical definition. Pdf reversible dementia due to two coexisting diseases. This being said many studies have fairly established that a significant. Pdf reversible dementia from corticosteroid therapy. The womans case of reversible dementia highlights just how much vitamin b12 does for the body. This activity is intended for neurologists and neurosurgeons, fmpc, internists, and geriatricians. Reversible dementia and gait disturbance after prolonged.
Dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life. Another group of patients who present with symptoms or complaints of impaired thinking are erroneously diagnosed as suffering from dementia. In the literature, the most frequently observed potentially reversible conditions identified in patients with cognitive impairment or dementia are depression, adverse. Reversible and irreversible cognitive disorders gulf bend. Overall, the findings suggest that pseudodementia may confer an increased risk of irreversible dementia in older patients. Dementia is a term that refers to a gradual or sudden loss of a persons cognitive abilities.
This can be due to some medical condition or even a psychological problem. Cognitive andor behavioral changes severe enough to impair daily. While many of the disorders reported as reversible dementias are conditions that may well be associated with cognitive or behavioral. American psychiatric associationdiagnostic and statistical manual of mental disorders. Evidence from studies on the investigation of dementia and case reports of conditions. Parkinsons disease, other forms of dementia or problems with balance could actually have a reversible form of cognitive and motor deterioration, says neurosurgeon daniele rigamonti. Reversible conditions that can lead to dementia like symptoms include.
Reversible and irreversible cognitive disorders rudolph c. Background in 1988, 2 metaanalyses suggested that the prevalence of reversible dementia was significantly lower than had been previously estimated. Diagnostic and statistical manual of mental disorders. The concepts of potentially reversible cognitive impairment in general, and the reversible dementias in particular, remain controversial. After purchase, you can download the inservice from the receipt page or the email receipt. Different possible causes of reversible dementias or dementialike symptoms are. Trivedi1, puneet narang2 introduction dementia is defined as a progressive impairment of cognitive functions occurring in clear consciousness i. Nov 11, 2014 reports indicate that as many as five out of every 100 people older than 65 who are diagnosed with alzheimers disease, parkinsons disease, other forms of dementia or problems with balance could actually have a reversible form of cognitive and motor deterioration, says neurosurgeon daniele rigamonti, an expert in the field of normal pressure hydrocephalus nph. Grayingpopulation by 2030 there may be 70 million elderly in theby 2030, there dementiamay be dementia70 million elderly in the united states currently around 35 million current prevalence rates of dementia 68% if older than 65. The word dementia describes a set of symptoms that may include memory loss and difficulties with thinking, problemsolving or language. Reversible dementia in the elderly as a rare manifestation of. Reversible dementia and gait disturbance as a result of.
It isnt a specific disease, but several different diseases may cause dementia. Pdf dementia has a reversible cause in some cases, and these should be diagnosed without overinvestigating the. Reversible dementia in the elderly as a rare manifestation. The last 20 years have witnessed a dramatic change in the way cognitive impairment, particularly dementia, has been seen. Angiography confirmed a dural arteriovenous malformation davm centered on the left. Dementia is a common disorder among older persons, and projections indicate that the number of patients with dementia in the united states will continue to grow. Reversible dementia due to two coexisting diseases. It was predicted that further work would indicate an even lower rate. Also, the definition of those cases with potentially reversible conditions that actually do reverse remains a critical aspect in assessing. In honor of nccdp alzheimers disease and dementia care staff education week february 14 th to the 21 st, the nccdp has prepared or collaborated with other organizations to bring you state of the art staff inservices that include the power point, handouts, pretest, posttest and answers.
Any atypical case such as early age of onset, disproportionate symptoms that do not fit in a definite syndrome, the presence of a comorbid medical condition that are known to cause reversible dementia should raise the probability of reversible dementia. Mar 30, 2017 drugs steroids can develop dementialike cognitive symptoms that occur without the occurrence of psychosis, reversible on tappering and stopping drugs with anticholinergic effects lead to dementia on long term use antidepressants, antipsychotics, atropine, carbamazepine, first generation antihistamines, and antimuscarinics, etc. Author links open overlay panel archana verma md, dm a alok kumar md up, rims b. Dementia alzheimers disease and nonalzheimers dementias. The present study represents an updated metaanalysis of the true. A 51yearold man was referred for neurologic consultation because of increasing forgetfulness, difficulty walking, frequent falls, apathy, and decreased motivation to perform activities of daily living such as bathing, cooking, and driving, over a 6month period. Ten to 33 percent of the patients who present for evaluation of dementia are found to have a potentially reversible cause of dementia such as a metabolic, structural, or psychiatric condition. This booklet will help you understand your diagnosis and prepare for the changes ahead. The findings also indicate, however, that a significant proportion improve, while many remain burdened with their psychiatric condition, independent of organic dementia. The report does not, however, cover temporary and reversible forms of damage to the brain. Most of those that do cause dementia are meningiomas, and the symptoms may recede when the tumor is resected. Results mini mental state examination score before shunt operation was 9. Reversible dementia definition, free reversible dementia definition software downloads, page 2. E download the latest virus definition file ivdf on a pc with internet access.
Alzheimer disease was still the commonest cause of dementia 56. Reversible dementia due to two coexisting diseases the lancet. The prevalence of these conditions depends to a great extent on the definitions used and on the population studied. Though dementia generally involves memory loss, memory loss has different causes. Many disorders which cause cognitive impairment, such as drug toxicity and depression, fail to meet diag. For a clinical diagnosis of dementia, deficits in memory and in at least one other cognitive domain must be documented, the deficits should interfere with occupational or social functioning, and there must be evidence of a systemic or brain disorder that may be the primary cause of the cognitive deficits american psychiatric association, 1993.
A person with dementia may also experience changes in their mood or behaviour. Eventually, dementia compromises the bodys ability to breathe and swallow and in the late stage, diseases causing dementia are fatal. Dementia is a very rare neurological manifestation of systemic lupus erythematosus sle and has a deep link with antiphospholipid antibodies apl and cerebral infarction in its development. We conclude that in elderly patients referred to a memory clinic, the prevalence of reversible dementia is of the order of 1%, if outcome after treatment is assessed by a standardized measurement. Evansa,1, ron shinarb,2, roy yaaria,c, auniversity of arizona college of medicine, phoenix campus, 550 east van buren street, phoenix, az 850042230, usa b banner good samaritan medical center department of medical imaging, phoenix az, 1111 e mcdowell rd, phoenix, az 85006, usa. Treatable intracranial conditions, systemic illnesses, endocrinopathies, deficiency states, collagenvascular disorders, heavymetal intoxications, exposure to industrial agents, infections, and the effects of drugs must all be considered in the evaluation of the patient with dementia. There are many potentially reversible causes of dementia, which may. Few common causes of reversible dementias are vitamin b12 deficiency, normal. Hence, it is difficult to say whether vitamin b12 is actually associated with reversible dementia or whether individuals with dementia have associated vitamin b12 deficiency. Dementia is a decline in mental abilities or cognitive functions such as memory, language, reasoning, planning, recognising, or identifying people or objects. Vascular dementia vad is a major contributor to the dementia syndrome and is described as having problems with reasoning, planning, judgment, and memory caused by impaired blood flow to the brain and damage to the blood vessels resulting from events such as stroke. Reversible dementia with parkinsonian features associated. Dementia word is derived from latin word dementatis meaning out of ones mind.
Plain head ct demonstrated dilated parenchymal vessels and vascular channels in the left occipital bone figure 1, a and b. The goal of this activity is to provide physicians with an activity that provides an overview of normal pressure hydrocephalus and its proper diagnosis and management. Reversible dementia and gait disturbance after prolonged use of valproic acid. In these cases of dementia, it is possible to improve memory. Full text get a printable copy pdf file of the complete article 3.
Diagnostic and statistical manual of mental disorders iii. Thus, while the etiology of a condition may be treatable it should not be assumed that the associated dementia is fully reversible. Chapter 6 reversible dementia 89 on t1weighted images, there are areas of diminished signal intensity with gadolinium enhancement in the corpus callosum. We describe a case of reversible dementia in an sle patient without apl or. Dementia is a clinical syndrome involving a sustained loss of intellectual functions and memory of sufficient severity to cause dysfunction in daily living. Slide 9 there also are some diseases or conditions that mimic dementia and are reversible. Dementia is reversible in some cases and these should be diagnosed without overinvestigating the many others with irreversible disease. Due to the presence of various biases selection, lack of blinded investigators, and others in the surveyed works, it is probable that the true incidence of reversible dementias in the community is even lower than that reported. In each case careful evaluation disclosed a reversible process. Few common causes of reversible dementias are vitamin b12 deficiency. However, nonvascular dementia irrelevant to apl or cerebral infarction has not been reported in patients with sle until now. Moskowitzthe diagnosis of reversible dementia in the. Of the 24 patients with reversible causes for dementia, 11 had neuroinfections, eight patients had normal.
Reversible dementias tripathi m, vibha d indian j psychiatry. Reversible dementia in elderly patients referred to a memory clinic article pdf available in journal of neurology 2441. Abstract two children who developed severe cognitive and behavioral deterioration while being treated with sodium valproate for idiopathic epilepsy are reported from the miami childrens hospital, miami, fl. Textbook of clinical neuropsychiatry neurofeedback. Common imaging findings among these reports demonstrate reversible cortical pseudoatrophy and enlargement of the lateral ventricles.