23 Tables.docx

Disorder Etiology...

Disorder Etiology Clinical Manifestations Onset/Course --------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Dementia due to HIV Infection with HIV-1 produces a dementing illness called HIV-1-associated cognitive/motor complex. Symptoms vary in early stages. Severe cognitive changes, particularly confusion, changes in behavior, and sometimes psychosis, are not uncommon in the later stages. At first symptoms are subtle and may be overlooked. The severity of symptoms is associated with the extent of the brain pathology. Dementia due to traumatic brain injury (see Module 11, Intracranial Regulation) Any type of head trauma. Amnesia is the most common neurobehavioral symptom following head trauma. A degree of permanent disturbance may persist. Dementia due to Parkinson disease Parkinson disease is a neurologic condition resulting from the death of neurons, including those that produce dopamine, the chemical responsible for movement and coordination. It is characterized by tremor, rigidity, bradykinesia, and postural instability. Dementia has been reported in approximately 20--60% of people with Parkinson disease and is characterized by cognitive and motor slowing, impaired memory, and impaired executive functioning. Onset and course are slow and progressive. Dementia due to Huntington disease Huntington disease is an inherited, dominant-gene, neurodegenerative disease. The first symptoms are typically movements that involve facial contortions, twisting, turning, and tongue movements. Cognitive symptoms include memory deficits, both recent and remote, as well as significant problems with frontal executive function, personality changes, and other signs of dementia. The disease begins in the late 30s or early 40s and may last 10--20 years or more before death. Lewy body dementia This disorder is distinguished by the presence of Lewy bodies---eosinophilic inclusion bodies---seen in the cortex and brainstem. Clinically, Lewy body disease is similar to Alzheimer disease; however, there is an earlier appearance of visual hallucinations and parkinsonian features. Irreversible and progressive; tends to progress more rapidly than Alzheimer disease. Vascular dementia Vascular dementia features strokes or infarcts in the blood vessels of the brain. Also caused by hypoperfusion due to blood clots, ruptured blood vessels, or narrowing or hardening of blood vessels. Symptoms vary widely, depending on the severity of the blood vessel damage and the part of the brain affected. Seizures often accompany strokes. Sudden poststroke changes may occur and include confusion, disorientation, trouble speaking or understanding speech, sudden headache, difficulty walking, poor balance, and numbness or paralysis on one side of the face or the body. Cognitive changes may occur suddenly after a stroke or they may have a slower onset. Progression typically follows a "sawtooth" pattern of strokes/ministrokes, followed by decline and stabilization until another vascular event occurs.