Assuntos
Demência Frontotemporal , Neuropsicologia , Sintomas Comportamentais/etiologia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Diagnóstico Diferencial , Empatia/fisiologia , Emoções Manifestas/fisiologia , Demência Frontotemporal/complicações , Demência Frontotemporal/diagnóstico , Demência Frontotemporal/psicologia , Humanos , Idioma , Testes NeuropsicológicosRESUMO
To determine the frequency of Alzheimer's disease (AD) pathology in patients presenting with progressive focal cortical syndromes, notably posterior cortical atrophy (PCA), corticobasal syndrome (CBS), behavioural variant frontotemporal dementia (bvFTD), progressive non-fluent aphasia (PNFA) (or a mixed aphasia) and semantic dementia (SD); and to compare the age of onset, evolution and prognosis in patients with focal cortical presentations of AD versus more typical AD and those with non AD pathology. From a total of 200 patients with comprehensive prospective clinical and pathological data we selected 120 : 100 consecutive cases with focal cortical syndromes and 20 with clinically typical AD. Clinical files were reviewed blind to pathological diagnosis. Of the 100 patients with focal syndromes, 34 had AD as the primary pathological diagnosis with the following distribution across clinical subtypes: all 7 of the PCA (100%); 6 of 12 with CBS (50%); 2 of 28 with bvFTD (7.1%); 12 of 26 with PNFA (44.1%); 5 of 7 with mixed aphasia (71.4%) and 2 of 20 with SD (10%). Of 20 with clinically typical AD, 19 had pathological AD. Age at both onset and death was greater in the atypical AD cases than those with non-AD pathology, although survival was equivalent. AD is a much commoner cause of focal cortical syndromes than previously recognised, particularly in PCA, PNFA and CBS, but rarely causes SD or bvFTD. The focal syndrome may remain pure for many years. Patients with atypical AD tend to be older than those with non-AD pathology.
Assuntos
Doença de Alzheimer/patologia , Córtex Cerebral/patologia , Idade de Início , Idoso , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Afasia Primária Progressiva/diagnóstico , Afasia Primária Progressiva/patologia , Afasia Primária Progressiva/psicologia , Atrofia/diagnóstico , Atrofia/patologia , Transtornos Cognitivos/etiologia , Demência/diagnóstico , Demência/patologia , Demência/psicologia , Diagnóstico Diferencial , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Análise de Sobrevida , SíndromeAssuntos
Afasia Primária Progressiva/diagnóstico por imagem , Afasia Primária Progressiva/patologia , Lobo Parietal/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Lobo Temporal/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Humanos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Método Simples-CegoRESUMO
We report the case of a 47-year-old man who presented with a few months' history of right-sided headache and dysphagia, with ipsilateral tenth and twelfth cranial nerve palsies on examination. The initial MRI showed an enhancing mass lesion in relation to the right carotid sheath and jugular foramen, and was reported as a possible paraganglioma. Subsequent angiography performed to assess tumour vascularity demonstrated a dissection involving a tonsillar loop of the right internal carotid artery (ICA). Imaging findings at MRI and angiography and the presentations and mechanisms of ICA dissection are briefly discussed.
Assuntos
Dissecação da Artéria Carótida Interna/complicações , Doenças do Nervo Hipoglosso/etiologia , Doenças do Nervo Vago/etiologia , Dissecação da Artéria Carótida Interna/diagnóstico , Tumor do Corpo Carotídeo/diagnóstico , Diagnóstico Diferencial , Humanos , Doenças do Nervo Hipoglosso/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças do Nervo Vago/diagnósticoRESUMO
Unlike the incidence of equine protozoal myeloencephalitis (EPM), which appears to be increasing, headshaking is an uncommon problem for horses in Missouri and the adjacent states. Equine protozoal myeloencephalitis was incriminated in three horses examined for the treatment of headshaking on the basis of a neurological examination, an analysis of cerebrospinal fluid and their response to treatment. The headshaking and stereotypical behaviour associated with EPM was successfully treated with potentiated sulphonamides and pyrimethamine.