Pick's disease
Alternative names:
aphasia-agnosia-apraxia syndrome; Arnold Pick's disease; cerebral atrophy; circumscribed brain atrophy; lobar sclerosis; presenile dementia
Symptoms:
Movement/coordination difficulties (apraxia)--may be one of the earliest symptoms
Mood changes, personality changes: - striking loss of concern and lack of anxiety
- loss of initiative
- flat affect (does not display any emotion)
- indecision
- inappropriate mood
- lack of spontaneity
- decreased interest in daily living activities
- impaired judgment
Behavior changes: - excessive manual exploration of the environment
- withdrawal from social interaction
- inability to function or interact in social or personal situations
- inability to maintain employment
- decreased ability to function in self care
- behavior that is inappropriate relative to the environment
Language changes: - echolalia (repetition of anything spoken to the person)
- speech is incomprehensible jargon
- aphasia (decreased language ability, difficulty speaking or understanding speech)
- inability to comprehend speech
- inability to speak
- inability to repeat a phrase
- poor enunciation
- decreased ability to read or write
- inability to name objects
Other changes: - loss of cognitive/intellectual skills
- specific disorders of problem solving/learning:
- inability to generalize
- loss of abstract thinking
- impaired calculating ability
- inability to learn
- weakness
- increased muscle tone
- urinary incontinence
- progressive dementia
- memory loss
Signs and tests:
The health care provider bases on initial diagnosis on history and symptoms, signs, and tests, and by ruling out other causes of dementia including dementia due to metabolic causes. Neurologic examination may reveal signs that vary according to the anatomic site of involvement. Temporal and frontal lobe signs are most common, with resulting behavioral and language changes. There may be other abnormalities, including frontal release signs (presence of abnormal reflexes) and abnormal levels of "normal" reflexes. Psychologic studies and tests of sensation, cognitive function, and motor function may be abnormal.
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