Rapidly progressing dementia: Difference between revisions
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m (Text replacement - "Creutzfeld-Jakob disease" to "Creutzfeldt-Jakob disease") |
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* Subacute and accelerated decline, developing over 2 years |
* Subacute and accelerated decline, developing over 2 years |
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* Must rule out |
* Must rule out Creutzfeldt-Jakob disease (CJD) |
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== Differential Diagnosis == |
== Differential Diagnosis == |
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* |
* Creutzfeldt-Jakob disease (CJD) |
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* Atypical course of a more common form of dementia |
* Atypical course of a more common form of dementia |
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** Frontotemporal dementia, progressive supranuclear palsy, Lewy Body dementia, and Alzheimer dementia |
** Frontotemporal dementia, progressive supranuclear palsy, Lewy Body dementia, and Alzheimer dementia |
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* Neurodegenerative |
* Neurodegenerative |
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** Alzheumer dementia |
** Alzheumer dementia |
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** |
** Creutzfeldt-Jakob disease |
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* Frontotemporal syndrome |
* Frontotemporal syndrome |
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** Behavioural variant frontotemporal dementia |
** Behavioural variant frontotemporal dementia |
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Revision as of 15:32, 5 November 2020
- Subacute and accelerated decline, developing over 2 years
- Must rule out Creutzfeldt-Jakob disease (CJD)
Differential Diagnosis
- Creutzfeldt-Jakob disease (CJD)
- Atypical course of a more common form of dementia
- Frontotemporal dementia, progressive supranuclear palsy, Lewy Body dementia, and Alzheimer dementia
- Limbic encphalitis: short-term memory loss, executive dysfuntion, personality changes, panic attacks, and delusions and hallucinations, as well as seizures
- Paraneoplastic syndromes
- Anti-Hu: often found in small cell lung cancer
- CV2: only found in small cell lung cancer or thymoma
- Ma2: testicular germ-cell tumours, breast cancer, and NSCLC
- VGKC
- Anti-voltage-gated potassium channel encephalopathy (VGKC-E): often has hyponatremia
- HSV encephalitis
- Paraneoplastic syndromes
- Hashimoto encephalitis (steroid-responsive encephalopathy): often in patients with other autoimmune disorders, diagnosed with anti-TPO and anti-TG antibodies
Investigations
- MRI: CJD is the only degenerative condition that causes hyperintensities in DWI and FLAIR
Extended Differential Diagnosis
- Vascular
- Stroke, vascular dementia
- CADASIL
- Thrombotic thrombocytopenic purpura (TTP)
- Hyperviscosity
- Syndromes/paraproteinemias (polycythemia, monocloncal gammopathies)
- Hypoxic-ischemic encephalopathy
- Infectious
- Whipple disease
- Syphilis
- Lyme disease
- Subacute sclerosing panencphalitis (SSPE) (measles)
- HIV-associated dementia
- Progressive multifocal leukoencephalopathy (JC virus)
- Toxic/metabolic
- Vitamin B12 deficiency
- Thiamine deficiency
- Niacin deficiency
- Folate deficiency
- Uremic encephalopathy
- Wilson disease
- Hepatic encephalopathy
- Porphyria
- Heavy metals
- Bismuth toxicity
- Alcohol toxicity
- Lithium toxicity
- Mercury toxicity
- Arsenic toxicity
- Lead
- Electrolyte abnormalities
- Kuf disease
- Methylmalonic acidemia
- Mitochondrial encephalopathies
- Autoimmune
- Paraneoplastic limbic encephalitis
- Anti-VGKC-E
- Hashimoto encephalopathy
- Lupus cerebritis
- Sarcoid
- CNS vasculitis
- Celiac disease
- Metastases/neoplastic
- CNS metastases
- Primary CNS lymphoma
- Intravascular lymphoma
- Lymphomatoid granulomatosis
- Gliomatosis cerebri
- Iatrogenic/idiopathic
- Central pontine myelinolysis
- Insulin-induced hypoglycemia
- Normal pressure hydrocephalus (NPH)
- Neurodegenerative
- Alzheumer dementia
- Creutzfeldt-Jakob disease
- Frontotemporal syndrome
- Behavioural variant frontotemporal dementia
- Semantic dementia
- Progressive non-fluent aphasia
- Frontotemporal dementia-motor neuron disease
- Parkinson syndrome
- Dementia with lewy bodies
- Corticobasal degeneration
- Progressive supranuclear palsy
- Parkinson disease dementia
- High definition
- Systemic
- Vasculitis (giant cell arteritis)
- Sleep apnea
