Subcortical dementia

12 important questions on Subcortical dementia

What are treatment options for Parkinson's?

- Medication
- Psychological (psychoeducation)
- DBS

How is Corticobasal Degeneration, a parkinsonian disorder, characterized?

- Signs from the basal ganglia: akinesia, rigidity
- Alien hand syndrome
- Dementia: apraxia
- Degeneration basal ganglia

How is Processive Supranuclear Palsy, a parkinsonian disorder, characterized?

- Bradykinesia
- Dementia: fronto-subcortical pattern
- Eye movement disorders - vertical supranuclear palsy, postural instability
- Basal ganglia, brainstem, cerebellum, frontal cortex
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How is Huntingon's disease characterized?

Motor dysfunction:
- Excessive unwanted movements - chorea
- Slowing of wanted movements - bradykinesia
Mood and behavior:
- Apathy, irritability, depression, OCD
Cognitive dysfunction:
- Dementia

How are cognitive aspects affected in Huntington's?

- Executive functioning: attention, visual, inflexibility, disinhibition
- Psychomotor speed: slowness
- Memory: working, defective retrieval
- Language: only affected in later stages
- Emotion recognition: diminished recognition of negative emotions
- Global: only in later stage

What is vascular dementia?

Temporal relation between cognitive changes and vascular events or clinical symptoms related to vascular changes.

What characterized vascular dementia?

- Cognitive deficits in executive functioning, fatigue, language and speech.
- Mood: intact disease insight - depression 60%

How is CADASIL, a form of vascular dementia, characterized?

- Cerebral Autosomal Dominant Arteriopathy (damage to blood vessel) with Subcortical Infarcts and Leucoencephalopathy
- NOTCH3 mutation chromosome 19
- Dementia
- Progressive damage to the brain

How is HCHWA-D, a form of vascular dementia, characterized?

- Hereditary Cerebral Hemorrhage With Amyloidosis (sticks to the blood vessels in the brain) - Dutch type
- Also called Katwijkse ziekte
- BetaPP gene mutation chromosome 21
- Dementia

What are symptoms in Normal Pressure Hydrocephalus?

- Cognitive deficiits: psychomotor slowing, impaired attention, executive and visuospatial dysfunction
- Gait disturbance
- Urinary incontinence

What are diagnostic criteria for Creuzfeld Jacob's Disease?

- Fast progressive dementia
- At least two of: myoclonus, visual or cerebellar disorders, piramidal signs, akinetic mutism
- Specific EEG abnormalities or positive 14-3-3-liquor test and duration <2 years

What are diagnostic criteria for variant CJD?

- Progressive neuropsychiatric
- Duration >6 months
- Routine care
- At least four of: early psychiatric symptoms, persistent painful sensibility disorders, ataxia, myoclonus, chorea or distonia, or dementia

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