神经病学精品教学：ALZHEIMER DISEASE.pptVIP

ALZHEIMER DISEASE Outline the definition of the dementia Diseases that cause Dementia Alzheimer disease: Epidemiology; Etiology and Pathology Clinical findings of AD Diagnosis and Differential Diagnosis of AD Treatment for AD Dementia A syndrome that may be caused or characterized by multiple cognitive deficits, which include memory impairment and at least one of the following: aphasia, apraxia, agnosia, or disturbance in executive functioning. Social or occupational function is also impaired. A diagnosis of dementia should not be made during the course of a delirium. (DSM-IV) Diseases that cause Dementia Alzheimer disease, Parkinson disease, Huntington disease, Amyotrophic lateral sclerosis with dementia, Pick disease, dementia with Lewy body; Vascular/multi-infarct; Metabolic/toxic/nutritional Infectious: encephalitis, AIDS, neurosyphilis, Creutzfeldt-Jakob disease. Hydrocephalus Head injury Intracranial mass lesion Illness other than in the brain Alzheimer disease Epidemiology first described by Alois Alzheimer in 1906 begins after 65, and risk goes up with age Etiology and pathogenesis Heredity: APP, PS1, PS2, apoE4 environmental factors: head injury, aluminium intoxication Neurochemical dysfunction: Ach descreased Pathology Senile plaques: APP deposited in its center Neurofibrillary tangles(NFTs) mainly the loss of cholinergic neuron in superficial cortex granulovacuolar degeneration note wide sulci caused by narrowed [lost tissue] gyri senile plaques Neurofibrillary tangles(HE stain) Clinical findings memory impairment (typically the first sign) forgetfulness , have trouble remembering recent events, activities, or the names of familiar people or things. Cognitive impairment: Time and place disorientation. get lost on their own street Clinical findings Psychiatric symptoms Changes in mood or behavior Changes in personality, such as becoming extremely confused, suspicious, fearful Oth