{"id":48267,"date":"2014-07-21T18:05:49","date_gmt":"2014-07-21T22:05:49","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=48267"},"modified":"2014-07-21T18:55:37","modified_gmt":"2014-07-21T22:55:37","slug":"needs-looking-into","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2014\/07\/21\/needs-looking-into\/","title":{"rendered":"needs looking into…"},"content":{"rendered":"\n


Emil Kraepelin           Alois Alzheimer          Auguste Deter<\/sup><\/p>\n

In 1907, Alois Alzheimer working in the lab of Emil Kraepelin, presented the brain findings on his patient, Auguste Deter, a woman who had died after developing dementia at age 51. Besides general brain shrinkage, there were characteristic microscopic findings: plagues in the extracellular spaces and neurons with neuro·fibrillary tangles in the cytoplasm. <\/p>\n

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Plaques were known from cases of senile dementia, but the tangles were felt to be a unique finding in pre·<\/strong>senile dementia. Kraepelin immortalized his colleague after Alzheimer’s untimely death by using his name in his classification. When I was a medical student, I was taught that the term Alzheimer’s Disease was reserved for the pre·<\/strong>senile cases, but in recent times, that distinction has fallen by the wayside – so Alzheimer’s Disease is a progressive dementia with characteristic brain findings.<\/p>\n

There are a number of neurodegenerative diseases with distinguishing features listed in the DSM-5: Alzheimer’s disease, Frontotemporal lobar degeneration, Lewy body disease, Vascular disease, Traumatic brain injury, Substance\/medication use, HIV infection, Prion disease, Parkinson’s disease, Huntington’s disease, Another medical condition, Multiple etiologies, Unspecified. In the case of Alzheimer’s, the diagnostic feature has formerly only be seen at autopsy, though there are apparently scans and other tests becoming available for antemortem diagnosis. There is a rare form that runs in families with a genetic marker and the findings are seen in the dementia that can develop with Down’s Syndrome. Since there’s no sure diagnosis in life, the DSM-5 provides probable<\/font><\/strong><\/em> and possible<\/font><\/strong><\/em> variants.<\/p>\n

The DSM-5 added yet another distinction – a syndromatic diagnostic pair: Major Neurocognitive Disorder<\/font><\/strong> and Mild Neurocognitive Disorder<\/font><\/strong>. So now there are four possible Alzheimer’s diagnoses:<\/div>\n