Neurological dementias

2013 ◽  
Author(s):  
Andrew Graham
Keyword(s):  
Multiple Sclerosis ◽  
Old Age ◽  
Normal Pressure Hydrocephalus ◽  
Neurological Disorders ◽  
Limbic Encephalitis ◽  
Later Life ◽  
Normal Pressure ◽  
Accurate Diagnosis ◽  
Autoimmune Limbic Encephalitis ◽  
Neurological Conditions

Dementia in old age is usually due to Alzheimer’s disease, cerebrovascular disease, or mixed pathology. Dementia due to other neurological disorders is uncommon, but important to recognise because management may be very different to that in primary or vascular dementia. This chapter surveys five neurological conditions that may present with dementia in later life: idiopathic normal pressure hydrocephalus (INPH); Huntington’s disease (HD); multiple sclerosis (MS); autoimmune limbic encephalitis (LE); and prion disease. For each disorder the epidemiology, clinical features, investigations & treatment are reviewed, with examples of the characteristic brain imaging changes. Accurate diagnosis of these conditions can be challenging even for physicians with a special interest in dementia, and often requires a neurological referral.

Neurological dementias

2020 ◽  
pp. 527-544
Author(s):  
Andrew Graham
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrovascular Disease ◽  
Old Age ◽  
Normal Pressure Hydrocephalus ◽  
Special Interest ◽  
Later Life ◽  
Normal Pressure ◽  
Accurate Diagnosis ◽  
Autoimmune Limbic Encephalitis ◽  
Neurological Conditions

Dementia in old age is usually due to Alzheimer’s disease, cerebrovascular disease, or mixed pathology. Dementia due to other neurological disorders is uncommon, but important to recognize because management may be very different to that in primary or vascular dementia. This chapter surveys five neurological conditions that may present with dementia in later life: idiopathic normal pressure hydrocephalus (INPH); Huntington’s disease (HD); multiple sclerosis (MS); autoimmune limbic encephalitis (LE); and prion disease. For each disorder it reviews the epidemiology, clinical features, investigations, and treatment, with examples of the characteristic brain imaging changes. Accurate diagnosis of these conditions can be challenging even for physicians with a special interest in dementia, and often requires a neurological referral.

Neurology

2019 ◽  
Author(s):  
Ross Paterson ◽  
Laszlo Sztriha
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Practice ◽  
Early Treatment ◽  
Neurological Disorders ◽  
Disease Diagnosis ◽  
Accurate Diagnosis ◽  
The Other ◽  
The Face ◽  
The Common

The face of neurology in clinical practice is changing. Neurology is no longer primarily a diagnostic specialty. As more therapeutic treatments become available in all fields from epilepsy to multiple sclerosis, early and accurate diagnosis is increasingly required so that patients can benefit from early treatment aiming to reduce the lifelong burden of neuro­logical disease. Diagnosis of neurological disorders is often considered by junior doc­tors to be highly complex and, as such, is responsible for a great deal of anxiety. One of the most difficult challenges can be determining the loca­tion of the lesion. A helpful approach to this is by analysis of the patterns that each lesion produces. Table 8.1 describes some of the common patterns seen in clinical practice, and the questions in this chapter will attempt to highlight some of the other specific presentations needed in assessing the neurology patient.

Normal Pressure Hydrocephalus in Children and Young Adults

Neurosurgery ◽  
1987 ◽  
Vol 20 (6) ◽  
pp. 904-907 ◽  
Author(s):  
Gene H. Barnett ◽  
Joseph F. Hahn ◽  
Joann Palmer
Keyword(s):  
Young Adults ◽  
Normal Pressure Hydrocephalus ◽  
Neurological Disorders ◽  
Young Patients ◽  
Normal Pressure ◽  
Neurological Dysfunction ◽  
Neurological Deficits ◽  
Normal Ranges ◽  
Ventriculoperitoneal Shunting ◽  
Children And Young Adults

Abstract Normal pressure hydrocephalus (NPH) is generally considered to be a disorder of adult and geriatric patients. We report four patients who are children or young adults with chronic neurological disorders, recent deterioration of their levels of function, normal cerebrospinal fluid (CSF) pressures, and ventricular enlargement. All four patients improved after the placement or revision of a ventriculoperitoneal shunt. Frequent symptoms and signs included irritability (three patients), vomiting (three patients), and abnormal limb posturing (two patients). Correct diagnosis was hampered by two factors: (a) Multiple or prolonged recordings of CSF pressures were invariably well within the normal ranges with respect to age, and (b) the patients had chronic neurological deficits. After ventriculoperitoneal shunting, subjective and objective improvement was seen in all cases. Young patients with large ventricles may benefit from shunting procedures despite low CSF pressures. These patients may be clinically identified by symptoms of new neurological dysfunction in cases of previously static neurological disease or acceleration of slowly progressive neurological dysfunction. Some of these underlying neurological disorders may predispose children and young adults to NPH.

Unusual Patient with Multiple Sclerosis and Shunt-Responsive Normal-Pressure Hydrocephalus

2011 ◽  
Vol 22 (1) ◽  
pp. 101-104 ◽  
Author(s):  
O. Algin ◽  
O. Taskapilioglu ◽  
B. Hakyemez ◽  
M. Parlak
Keyword(s):  
Multiple Sclerosis ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure

scholarly journals A-255 Severe Psychological Dysfunction in a Neurologically Complex Patient during a Pre-Surgical Evaluation for Normal Pressure Hydrocephalus Shunt Implantation

2020 ◽  
Vol 35 (6) ◽  
pp. 1050-1050
Author(s):  
Wisinger A ◽  
Fink J
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Focal Epilepsy ◽  
Executive Dysfunction ◽  
Normal Pressure ◽  
Self Report ◽  
Traumatic Experiences ◽  
Case Formulation ◽  
Shunt Implantation ◽  
Obstructive Sleep ◽  
Neurological Conditions

Abstract Objective Psychological syndromes like depression and anxiety are common in neurological conditions and lead to poorer quality of life and disability. However, these syndromes are often under-recognized in neurologic patients and are thus under-diagnosed due to overlapping symptomatology. Here, we report on a patient with a complex neurological history as well as clinically significant affective symptoms. Participants The patient is a 69-year-old Caucasian female recently diagnosed with normal pressure hydrocephalus. Relevant medical history was significant for focal epilepsy with complex seizures, obstructive sleep apnea, and cerebrovascular accident. She underwent neuropsychological evaluation as part of a pre-surgical workup for shunt implantation. Results The patient’s neurocognitive profile was marked by significant impairments in most cognitive domains and she was not independent in activities of daily living. On self-report measures of current emotional functioning, she reported clinically severe levels of depression, anxiety, apathy, executive dysfunction, and disinhibition. During the clinical interview, she reported experiencing passive suicidal ideation as well as a significant history of traumatic experiences. Conclusion The psychological symptoms the patient was experiencing undoubtedly impacted her neurocognitive status and functioning abilities, though she was receiving no treatment for these symptoms. Addressing symptoms resulting from psychological syndromes in patients with neurological conditions is an important role for neuropsychologists, as accurate diagnosis of psychological syndromes can inform treatment recommendations and improve patient outcomes. This case illustrates the importance of documenting a thorough clinical history, including past psychiatric history, as well as a detailed examination of self-reported current psychological functioning as part of a comprehensive neuropsychological case formulation.

Cerebrospinal Fluid Alzheimer’s Biomarkers and Neurofilament Light Profile of Idiopathic Normal Pressure Hydrocephalus in China: A PUMCH Cohort Study

2021 ◽  
pp. 1-8
Author(s):  
Chenhui Mao ◽  
Longze Sha ◽  
Caiyan Liu ◽  
Shanshan Chu ◽  
Jie Li ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cohort Study ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Accurate Diagnosis ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Standard Protocol ◽  
Neurofilament Light ◽  
Csf Biomarker ◽  
And Control

<b><i>Introduction:</i></b> Idiopathic normal pressure hydrocephalus (iNPH) is one of the potentially reversible dementias. Early and accurate diagnosis is important for patients’ prognosis. Emerging evidence shows fluid biomarkers are useful in diagnosis and pathophysiological research of iNPH. <b><i>Methods:</i></b> Probable iNPH and Alzheimer’s disease (AD) patients were recruited. Clinical diagnosis was performed according to international guidelines. CSF collection complied with a standard protocol. Commercial accessible ELISA kits were introduced for measurement of CSF <i>t</i>-tau, <i>p</i>-tau<sub>181</sub>, Aβ<sub>42</sub>, and NfL. <b><i>Results:</i></b> Twenty-seven iNPH, 27 AD, and 18 controls were included. The profiles of CSF <i>t</i>-tau, <i>p</i>-tau<sub>181</sub>, and <i>t</i>-tau/Aβ<sub>42</sub> in the iNPH and AD were significantly different (<i>p</i> &#x3c; 0.0001). The profiles of CSF <i>t</i>-tau, <i>p</i>-tau<sub>181</sub>, and <i>t</i>-tau/Aβ<sub>42</sub> in the iNPH and control were not different (<i>p</i> &#x3e; 0.05). Level of CSF Aβ<sub>42</sub> in iNPH was significantly lower than control (<i>p</i> &#x3c; 0.0001) and also significantly higher than AD (<i>p</i> &#x3c; 0.05). NfL level in iNPH and AD was increased, but its level in iNPH was significantly lower than that in AD (<i>p</i> = 0.005). NfL and <i>t</i>-tau level in the iNPH group was significantly correlated (coefficient = 0.649, <i>p</i> = 0.005), but not in AD (coefficient = 0.298, <i>p</i> = 0.157). <b><i>Conclusion:</i></b> Alzheimer’s CSF biomarker profile of iNPH subjects showed moderately decreased Aβ<sub>42</sub> and normal <i>t</i>-tau, <i>p</i>-tau<sub>181</sub>, and <i>t</i>-tau/Aβ<sub>42</sub>, which was distinguishable from AD. The different profiles and correlation of <i>t</i>-tau and NfL suggested different pathophysiology of AD and iNPH. <i>t</i>-tau was relatively an AD-specific neurodegenerative biomarker compared to NfL.

Images of Aging in the Psychotherapeutic Context

GeroPsych ◽  
2015 ◽  
Vol 28 (2) ◽  
pp. 47-55 ◽  
Author(s):  
Eva-Marie Kessler ◽  
Catherine E. Bowen
Keyword(s):  
Old Age ◽  
Diagnostic Tests ◽  
Aging Process ◽  
Developmental Psychology ◽  
Mental Representations ◽  
Later Life ◽  
Future Research ◽  
Psychotherapeutic Process ◽  
Images Of Aging ◽  
Client Communication

Both psychotherapists and their clients have mental representations of old age and the aging process. In this conceptual review, we draw on available research from gerontology, social and developmental psychology, and communication science to consider how these “images of aging” may affect the psychotherapeutic process with older clients. On the basis of selected empirical findings we hypothesize that such images may affect the pathways to psychotherapy in later life, therapist-client communication, client performance on diagnostic tests as well as how therapists select and apply a therapeutic method. We posit that interventions to help both older clients and therapists to reflect on their own images of aging may increase the likelihood of successful treatment. We conclude by making suggestions for future research.

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