Alzheimer’s Disease

• The most common cause of Dementia– Progressive Memory Loss

Plus loss in one other area of cognition:• Perception• Attention• Language/Symbols• Judgment• Reasoning• Problem Solving

• Interferes with Activities of Daily Living• Other causes (stroke) and mimics (depression) ruled

out

Prion Disease

• Often confused with Alzheimer’s disease clinically

• Progressive dementia

• Course is much more rapid

• Myoclonus, startle

• Cerebellar signs (variable)

Mild Cognitive Impairment (MCI)

• Memory Complaint• Abnormal memory for age and educational

background• Not demented

– Dementia is cognitive problems with impairment in social or occupational function, and trouble with language, coordinating physical activities, or thinking through problems

• About 12% with MCI develop AD per year

Progressive Supranuclear PalsyPSP

• Second most common cause of parkinsonism after Parkinson’s disease

• Rigidity, symmetric• eye movement abnormalities

– staring, limited

• frequent falls/postural instability• no treatment response, or, not sustained• poor prognosis

Corticobasal Degeneration

• alien limb phenomenon• Asymmetry• Apraxia• Dystonia• “cortical” signs, “frontal release”• Parkinsonism not responsive to treatment• Rapid progression• No family history

Parkinson’s Disease• Resting tremor• Bradykinesia• Rigidity• Postural instability• Gait difficulties• Asymmetric onset• Responsive to Dopamine replacement• Dysautonomia, sleep, non-Neurological symptoms

Lewy Body Dementia

• Second most common cause of dementia– Memory difficulties– Parkinsonism

• May be dopamine replacement responsive• Neuroleptic (dopamine antagonist) sensitive

– Fluctuations• Cognition• Motor symptoms

– May respond to cholinesterase inhibitors– Hallucinations, delusions– Sleep impairment (REM behavior disorder)