Neuro

Alzheimer's Disease

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Pathology

Presence of cerebral neuronal cell loss, senile plaques, neurofibrillary tangles and beta-amyloid deposition

Aetiology

Most common cause of dementia predominantly affecting memory. The age of onset is usually from 6th decade onwards

Signs

Rigidity, myoclonus and seizures in the late stages. 

Symptoms

Short Term Memory Loss: Progresses gradually to involve other cognitive domains 
Progressive Personality Changes: Apathy, wandering and emotional lability. 
Language Deficits: word finding difficulty, problems with reading and writing 
Advanced Stages: Mobility, speech, swallow and memory are severely affected. .

Investigations

Bloods: B12, TSH, Syphilis, HIV to screen for reversible causes of dementia
Imaging:  MRI or CT brain may show atrophy in the medial temporal lobe 

Treatment

Medical: Central cholinesterase inhibitors such as donepezil, galantamine and 
rivastigmine may slow disease progression. 
Symptomatic treatment with antidepressants or neuroleptics 
MDT Approach: Physiotherapy, occupational therapy, SALT and family input

Prognosis

The average life expectancy from the time of diagnosis is around 6-7 years, Death is usually due to sepsis.
Agitation, incontinence, depression, falls, wandering, self-neglect

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