Dr. Faisal Ali<\/p>\n
DLB and PDD are also the adumbrated portraits of Dementia that portray themselves with the Levodopa responsive Parkinsonism, Cortical symptoms and Autonomic disorder<\/p>\n
The hippodrome of dementia is flooded with diseases but the quartet of Alzheimer disease, dementia with Lewy bodies, Parkinson disease and Normal Pressure Hydrocephalus (NPH) is the gargantuan screenplay of degenerative disorders that has been the knelling bell for old population around the globe. In order to curtail these pestilential vulnerabilities, a sincere effort is needed by the neurologists and psychiatrists of the orb to ferret out pragmatic remedies for scintillating merriment in the eyes of affected people. Dementia is defined as a progressive decline in two or more areas of cognition that is sufficient to interfere with work, social function, or relationships. The areas of cognition included in the definition are memory, language, abstract thinking, praxis, visuospatial or perceptual skills, executive function, personality & social behavior.1 Alzheimer\u2019s disease is the prominent reason for dementia around the orb that affected approximately 5.8 million Americans in 2014.2 The patho-physiology is due to deposits of Amyloid A4 protein in the Cortex with neuritic plaques and presence of tain tau plus Ubiquitin proteins in Neurofibrillary tangles.
\nSimilarly, Dementia with Lewy Bodies (DLB) and Parkinson\u2019s disease Dementia (PDD) are also the adumbrated portraits of Dementia that portray themselves with the Levodopa responsive Parkinsonism, Cortical symptoms and Autonomic disorder. The pathophysiology of these two disorders includes Progressive Cell degeneration in Substantia Nigra & Lewy body inclusions in Cortical neurons.\u00a0
\nIn the same arena of maladies, Normal Pressure Hydrocephalus (NPH) is a brain disorder that is often misdiagnosed as Alzheimer\u2019s or Parkinson\u2019s disease.4 An excess amount of CSF accumulates in the brain\u2019s ventricles which represents itself in the form of a classic triad called Hakim\u2019s Triad that includes Dementia, gait instability and loss of bladder control.5 The diagnosis of NPH is confirmed by MRI or CT-Scan and therapy includes spinal tap and VP shunt implant.\u00a0
\nThe first line of investigations to diagnose any disorder that can cause dementia is Serum chemistry, TFTs, VDRL, TPHA & MRI. The secondary investigations include CSF examination, HIV, Genetic testing, EEG, Volumetric MRI, SPECT & Brain biopsy. It is further added that dementia must be differentiated from Catatonia that is a state in which someone is awake but does not respond to other people and their environment. It is often observed in people with depression, Bipolar Disorder, OCD, Post-Traumatic Stress Disorder (PTSD) and experiences of past trauma. In such type of situation, the role of psychiatrist along with other clinical disciplines becomes indispensible to track down the true nature of ailment. During my clinical practice in the second decade of 21st century, I\u00a0stumbled upon several elderly people who were smitten by\u00a0the quartet of neuro-degenerative disorders and to produce gold out of the old,\u00a0the clinicians of orb are awaiting new quantum leaps in therapeutic arena.
\nREFERENCES:-
\n1\tOxford handbook of Neurology, 2nd Edition (Pakistan Edition, 2017), Chapter 5, Neurological Disorders, Dementia, page 198.
\n2\t Matthews, K. A., Xu, W., Gaglioti, A. H., Holt, J. B., Croft, J. B., Mack, D., & McGuire, L. C. (2018). Racial and ethnic estimates of Alzheimer\u2019s disease and related dementias in the United States (2015\u20132060) in adults aged\u2265 65 years. Alzheimer\u2019s & Dementia. https:\/\/doi.org\/10.1016\/j.jalz.2018.06.3063.
\n3\tOxford handbook of Neurology, 2nd Edition (Pakistan Edition, 2017), Chapter 5, Neurological Disorders, page 202.
\n4\tNPH, Alzheimer\u2019s Association, alz.org.\u00a0\u00a0\u00a0
\n5\tNPH, Alzheimer\u2019s Association, alz.org.<\/p>\n
The writer is the medical graduate of Xi\u2019An Jiaotong University, P.R China and currently serves as medical officer at THQ Hospital, Tehsil Banda Daud Shah, District Karak, Pakistan. Can be reached at drfaisalali88@gmail.com<\/p>\n","protected":false},"excerpt":{"rendered":"
Dr. Faisal Ali DLB and PDD are also the adumbrated portraits of Dementia that portray themselves with the Levodopa responsive Parkinsonism, Cortical symptoms and Autonomic disorder The hippodrome of dementia is flooded with diseases but the quartet of Alzheimer disease, dementia with Lewy bodies, Parkinson disease and Normal Pressure Hydrocephalus (NPH) is the gargantuan screenplay […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[11397,11398,5118],"class_list":{"0":"post-294865","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-article","7":"tag-dementia","8":"tag-dr-faisal-ali","9":"tag-reflections"},"yoast_head":"\n