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Case of the Month – October 2018

By Dr Denis Gribbin

History:

61 year old woman with rapid cognitive decline over 2 years

Imaging:

FDG PET/CT of the brain

Findings:

CT brain shows basal ganglia calcification but is otherwise normal. PET/CT shows markedly reduced metabolic activity in bilateral temporal and parietal lobes.

The pattern is characteristic of Alzheimer’s disease. Nuclear Medicine Cerebral perfusion scans will show a similar pattern of hypoperfusion.

Management:

While there are currently no treatments available to slow or stop the brain damage caused by Alzheimer’s disease, several medications can temporarily help improve the symptoms of dementia for some people. These medications work by increasing neurotransmitters in the brain.
Reference:  https://www.alz.org/au/dementia-alzheimers-australia.asp#treatment

Differentiation:

How to distinguish between other common types of dementia:

  • Fronto-temporal Dementia as the name implies involves the fronto temporal cortex
  • Lewy Body Dementia is often associated with visual hallucinations and there may be involvement of occipital/visual cortex which can help differentiate it from Alzheimer’s.

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