DOC

Insidious Onset Gradual Decline

By Ernest Sanchez,2014-11-25 09:26
10 views 0
Insidious Onset Gradual Decline

    (E)Table 1. Key findings from the initial evaluation of the very mildly impaired patients who were inaccurately diagnosed with Alzheimer’s Disease

     or one of its variants. The initial clinical diagnosis (DX) and the final diagnosis are also shown.

     Insidious Onset/ Pertinent History Neurological Examination Hachinski Neuroimaging Depression Clinical DX Final DX (Clinical

    Gradual Decline Score (DIS) or Autopsy)

    (Rosen)

     Autopsy

    Diagnosis

    Patient # 1 Yes None Extrapyramidal Features 2 MRI: Generalized No Probable LBV Dementia with

    Atrophy and Deep Argyrophilic Grains

    White Matter Changes

    Patient # 2 Yes None Extrapyramidal Features 2 CT: Volume Loss No Probable LBV Progressive

    Limitation of Vertical Gaze Supranuclear Palsy

    Abnormal Coordination

    Gait Disorder

    Lower Motor Neuron Weakness

    Patient # 3 Yes None Extrapyramidal Features 2 CT: Normal Yes Probable LBV Vascular Dementia

    Limitation of Vertical Gaze (2 yrs. Before

    Abnormal Coordination ADRC Evaluation)

    Gait Disorder

Other Clinical

    Diagnosis

    Patient # 4 Yes Seizure Disorder, Normal 0 CT and MRI: Normal Yes Possible AD Traumatic Dementia

    Two Motor Vehicle

    Accidents with Loss

    of Consciousness

(E)Table 1 (Continued)

     Insidious Onset/ Pertinent History Neurological Examination Hachinski Neuroimaging Depression Clinical DX Final DX (Clinical

    Gradual Decline Score (DIS) or Autopsy)

    (Rosen)

     Other Clinical

    Diagnosis

    (Continued)

    Patient # 5 Yes Family History of Normal 0 None No Possible AD Familial

    Striato-Nigral Striato-Nigral

    Degeneration Degeneration

    Patient # 6 Yes None Normal 0 CT: Generalized No Probable AD Amnestic Disorder

    Atrophy

    Patient # 7 Yes Alcohol Abuse Extrapyramidal Features 5 MRI: Generalized No Probable AD Probable Progressive

    Hypothyroidism Limitation of Vertical Gaze Atrophy Supranuclear Palsy

    Abnormal Coordination

    Gait Disorder

Normal

    Patient # 8 Yes None Normal 0 CT: Small Left Yes Possible AD Normal

    Fronto-Parietal

    Hyperintensity (Poss.

    Meningioma)

    Patient # 9 Yes Cardiovascular Normal 0 CT: Normal No Probable AD Normal

    Disease

    Patient # 10 Yes None Normal 2 CT: Generalized No Probable AD Normal

    Atrophy (Later Treated)

    Patient # 11 Yes None Extrapyramidal Features 1 None No Probable AD Normal

    Patient # 12 Yes Hypothyroidism Normal 1 None No Possible AD Normal

    (E)Table 2. The mean score achieved by the normal control (NC) subjects and very mildly impaired

    patients with Alzheimer’s Disease (AD) on the neuropsychological test measures at the initial

    evaluation. Standard deviations are shown in parentheses.

     Neuropsychological Test NC Subjects AD Patients

    (n=98) (n=98)

     Global Mental Status

     Dementia Rating Scale (Max.=144; n=74) 137.7 (5.7) 120.0 (9.6)

     Attention

     WAIS-R Digit Span Subtest (Max.=19; n=93)