Résumé
We report a case of carcinomatous meningitis diagnosed at autopsy that was clinically diagnosed as a case of Creutzfeldt-Jakob disease (CJD) because of rapidly evolving dementia. Pathological study revealed diffusely spreading carcinomatous meningitis, infiltrating into cortex along Virchow Robin space. Immunostaining for Prion protein was negative. Despite advances in clinical diagnosis, tissue diagnosis remains a pre-requisite for confirmation of CJD.
Sujets)
Maladie de Creutzfeldt-Jakob/diagnostic , Diagnostic différentiel , Issue fatale , Femelle , Humains , Tumeurs des méninges/diagnostic , Adulte d'âge moyen , Métastase tumorale/anatomopathologieRésumé
OBJECTS: To assess the frequency of behavioural disturbances in patients suffering from dementia and their relation to dementia severity. METHODS: The study evaluated 75 patients referred to the Memory Clinic at our hospital. Patients meeting DSM-IV criteria for dementia were included in the study. Activities of daily living (ADL) and cognitive functioning were also assessed. Patients were then rated for dementia severity using the Clinical Dementia Rating scale. Clinical data regarding behavioural disturbances was obtained from the patient (where possible) and an informant (usually the primary caregiver) who had contact with the patient at least thrice a week. RESULTS: Results showed that behavioural disturbances were present in more than 60% of the sample. Psychotic and activity associated disturbances were most common, and that these were seen more frequently in Alzheimer's disease than any other type of dementia. Further, these disturbances occurred most frequently in dementias of moderate severity but reduced as the dementia progressed further. CONCLUSION: Our results indicate that behavioural disturbances are a prominent part of dementia and that judicious use of psychiatric medication should form an important aspect of management.
Sujets)
Activités de la vie quotidienne , Sujet âgé , Sujet âgé de 80 ans ou plus , Loi du khi-deux , Démence/complications , Femelle , Humains , Mâle , Troubles mentaux/étiologie , Adulte d'âge moyen , Indice de gravité de la maladieRésumé
We describe a series of 7 patients with temporal arteritis (TA), 5 of whom had undoubted TA and 2 almost certainly had TA. All presented with considerable morbidity but responded dramatically to treatment.