1/14. Pseudodementia in a twenty-one-year-old with bipolar disorder and vitamin B12 and folate deficiency.A twenty-one-year-old female known to suffer from bipolar type I disorder developed features of a pseudodementia. Following prompt initial response to treatment with antidepressants, there was an early recurrence of cognitive impairment. blood investigations confirmed a macrocytic anaemia and vitamin B12 and folate deficiencies. There was dramatic resolution of cognitive impairment after vitamin replacement. This suggested the occurrence of a reversible nutritional dementia and reinforced the need to rule out secondary organic causes of psychiatric symptoms even in patients previously diagnosed with a primary psychiatric disorder.- - - - - - - - - - ranking = 1keywords = pseudodementia (Clic here for more details about this article) |
2/14. Angular gyrus syndrome mimicking depressive pseudodementia.A 67-year-old left-handed woman with a diagnosis of pseudodementia was being treated for depression with little benefit. Neuropsychological evaluations revealed features of angular gyrus syndrome, namely, agraphia, alexia, Gerstmann's syndrome and behavioural manifestations such as depression, poor memory, frustration and irritability. A computed tomographic scan showed a right occipito-temporal infarction, which had occurred 18 months earlier. The patient demonstrated aspects of language dysfunction associated with the syndrome and showed reversed lateralization of cerebral functions. Recognizing and distinguishing between angular gyrus syndrome and depression is important because the appropriate therapies differ. The use of the term pseudodementia can be misleading.- - - - - - - - - - ranking = 6keywords = pseudodementia (Clic here for more details about this article) |
3/14. Depressive pseudodementia in a child with autism.depression is rare in early childhood and unusual in autism in this age group. We describe a female child aged 6 years with autism who presented with regression of developmental skills previously gained. Her sleep and appetite were poor, her affect was sad, and she had morbid speech content. She responded to treatment with antidepressant medication. When this clinical picture occurs in adults it is called depressive pseudodementia; paediatric neurologists and neuropsychiatrists need to be aware of it in children.- - - - - - - - - - ranking = 5keywords = pseudodementia (Clic here for more details about this article) |
4/14. A first episode of mania after age 80.The case of a patient whose first episode of mania (DSM-III-R diagnosis) occurred after age 80 is presented; the patient had no previous psychiatric illness. Diagnostic and therapeutic issues are discussed with special regard to features of mania in old age, secondary mania (organic mood syndrome), pseudodementia, MHPG excretion and carbamazepine treatment.- - - - - - - - - - ranking = 1keywords = pseudodementia (Clic here for more details about this article) |
5/14. A dementia syndrome of dependency?The diagnostic process in a case of dementia associated with physical and emotional dependence is described. The utility of sodium amylobarbitone abreaction is considered. The role of both psychodynamic and organic factors are emphasised in the aetiological work-up. The organic factors discussed include alcohol, sedative tranquillisers, solvents, and metals. The term 'pseudodementia' is not favoured, and the phrase 'dementia syndrome of dependency' is proposed.- - - - - - - - - - ranking = 1keywords = pseudodementia (Clic here for more details about this article) |
6/14. Clinical neurophysiology of dementia.The role of EEG in the study of the dementias is to help in the differential diagnosis of the multiple causes of this syndrome. EEG is useful in differentiating early on between treatable and as of now untreatable forms of dementia. Space-occupying lesions that give rise to dementia are reliably detected by EEG. Infectious, toxic, and metabolic processes are associated with early and severe electroencephalographic abnormalities. The "slow virus" infections show characteristic electrical patterns that reliably distinguish them from the cortical or subcortical dementias. Finally, the EEG may contribute to distinguishing between Alzheimer's disease and MID, two commonly occurring forms of dementia. The paucity of substantial early EEG abnormalities in Alzheimer's disease, although helping to differentiate it from other dementias, leaves us without a currently available physiologic test that provides positive evidence for this condition. Recent studies of EPs, however, suggest that some intermediate latency VEP components may be delayed in patients with Alzheimer's disease when compared with normal subjects. This is encouraging, as latencies in VEPs are more reliable and less variable than amplitude that has previously been reported as "abnormal" in some early Alzheimer patients. Long latency ERPs and CNV also show early abnormalities in Alzheimer's disease. Tests of eye movements such as ERPs are psychophysiologic tests requiring some degree of patient cooperation. Performance on tests of ocular smooth pursuit correlate highly with severity of the dementia syndrome in Alzheimer's disease. In contrast, smooth pursuit testing is usually normal in elderly patients with pseudodementia of depression, suggesting this test may be of some value in differentiating these two clinical disorders. Some evidence exists that smooth pursuit eye movements are also normal, at least in the early and middle stages, in Pick's disease, again suggesting that eye movement testing may prove to have some utility in differentiating this form of dementia from Alzheimer's disease. Ocular scanpaths are abnormal in dementia. They typically are poorly organized and at times perseveratory. In addition, the average durations of eye fixations during directed visual search are altered in dementia as compared with normals. The average eye fixation durations are longer with Alzheimer's disease and briefer in patients with frontal lobe tumors as compared with elderly normal controls. These group differences suggest differing scanning strategies for these two forms of dementia.(ABSTRACT TRUNCATED AT 400 WORDS)- - - - - - - - - - ranking = 1keywords = pseudodementia (Clic here for more details about this article) |
7/14. Mania and pseudodementia.A 73-year-old woman who was initially believed to be demented was later given the diagnosis of bipolar disorder, manic phase. Treatment with lithium carbonate resolved the mania and the apparent cognitive deficits.- - - - - - - - - - ranking = 4keywords = pseudodementia (Clic here for more details about this article) |
8/14. Intractable depression and pseudodementia: a report of two cases.Two cases are presented to illustrate some of the issues that arise in the management of patients diagnosed as suffering from the dementia syndrome of depression (Pseudodementia). Case 1 illustrates the dilemma of relatively normal autopsy findings in the brain in a patient presenting with a history of depression and dementia. Case 2 deals with a patient successfully treated for depression 14 years after the diagnosis of presenile dementia. Issues raised include the problem of labelling and the Rip Van Winkle situation of unanticipated recovery 14 years after this diagnosis was made. A planned approach to the treatment of pseudodementia systematically exploring available treatment options is recommended.- - - - - - - - - - ranking = 5keywords = pseudodementia (Clic here for more details about this article) |
9/14. A case report of dissociative pseudodementia.The authors report the case of a patient admitted to a medical hospital for seizures and considered for more than 1 month to be demented. Psychiatric examination revealed a fluctuating cognitive capacity, suggesting a psychogenic etiology. Following a sodium amytal interview, the patient's symptoms dramatically resolved. diagnosis, treatment, and the importance of considering dissociative pseudodementia are discussed.- - - - - - - - - - ranking = 5keywords = pseudodementia (Clic here for more details about this article) |
10/14. Single case study. Pseudodementia and mania.This case report extends the discussion of pseudodementia into the area of manic behavior. An elderly patient whose manic symptoms are considered to be an early sign of an organic brain syndrome should be given timely repeat evaluations before this diagnosis is allowed to guide treatment. Our case presentation emphasized the paucity of the data base we have to diagnose cognitive and emotional disturbances of the elderly. It is difficult to identify the essential features of cognitive dysfunction associated with primary neuronal degeneration especially in the early stages of the disease. A careful differential diagnostic evaluation is important to eliminate variables such as affective disorders and underlying physical conditions as causes of confusion and cognitive dysfunction in the elderly patient.- - - - - - - - - - ranking = 1keywords = pseudodementia (Clic here for more details about this article) |
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