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A Case Report

Parkinson’s disease dementia - A case report

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Page 1: Parkinson’s disease dementia - A case report

A Case Report

Page 2: Parkinson’s disease dementia - A case report

Parkinson's disease dementia is a decline in thinking andreasoning that develops in someone diagnosed withParkinson's disease, at least a year earlier.

Common symptoms include: Changes in memory, concentration and judgment; Trouble interpreting visual information; Muffled speech; Visual hallucinations; Delusions, especially paranoid ideas; Depression; Irritability and anxiety; Sleep disturbances, including excessive daytime drowsiness

and rapid eye movement (REM) sleep disorder.

Page 3: Parkinson’s disease dementia - A case report

An estimated 50 to 80 % of those with Parkinson'seventually experience dementia as their disease progresses.The average time from onset of Parkinson's to developingdementia is about 10 years.

Risk factors for dementia in patients with Parkinson'sdisease are as follows: Age 70 years or older; Score greater than 25 on the Parkinson's disease rating scale (PDRS); Depression, agitation, disorientation, or psychotic behavior under

levodopa therapy; Exposure to severe psychological stress; Cardiovascular disease; Low socioeconomic status; Low education level.

Page 4: Parkinson’s disease dementia - A case report

I’m going to present you the case of a 71 y.o. woman, aformer nurse, recently diagnosed with dementia inParkinson’s disease.

Her symptoms include: Resting tremor and hypertonia (rigidity) in all of the

members, bradykinesia, impared posture; Memory problems (especially for short term events); Ideomotor apraxia; REM sleep behavioral disorder; Infrequent hallucinations; Major depression.

Page 5: Parkinson’s disease dementia - A case report

The parts of the nervous system that are involved in herdisease are:

The telencephalic cortex (predominantly the frontal and temporal lobes);

The basal ganglia (the striatum) and the substanta nigra.

The functions that are impaired in this case are: The higher cognitive areas (memory, personality, the

executive functions like planning, calculus etc.).

The motor areas (the direct and indirect pathways -movement intiation and supression of involuntary movement).

Page 6: Parkinson’s disease dementia - A case report

At a young neurologist in training, this course has helpedme to better organize and integrate all the information inthe very vast domain of Neurology.

Due to long hours of clinical practice, I don’t always findthe necessary time and peace of mind to exhaustively readabout a subject from a medical manual, so this courseprovided a short, intensive trip through all the majorchapters of Neurology & Neuroanatomy.

Also, I should mention that the brain anatomy labs werereally helpful, since we don’t often get the occasion toactually see & touch our main subject (the brain) in reallife.