Alzheimer’s disease – symptoms, investigations, treatment
Characteristic pathological lesions are: cerebral atrophy with neuronal loss, senile plaques, amyloid angiopathy (accumulation in the cerebral vessels of amyloid deposits).
Alzheimer’s Disease Symptoms
Dementia syndrome of Alzheimer’s disease often begins by impaired memory of recent facts, isolated or associated with aphasic type language disorders (semantic aphasia) and gradually evolves into apraxo-agnosia syndrome. Neurological exam indicates the absence of sensory-motor deficits, of visual field changes and plantar cutaneous reflexes are in flexion.
Sometimes, in the course of evolution it will be identified a type of extrapyramidal hypertonia and generalized seizures. Progressive aggravation leads to a severe dementia syndrome, death will install after 7-10 years.
Electroencephalogram (EEG) shows a diffuse reduction in cortical rhythms (nonspecific, occurring in late states). Computer tomography (CT) indicates a cerebral cortical atrophy with a dilatation of spaces ventricular and distention of the cortical grooves cortical. Repeated CT’s or MRI’s indicates progressive atrophy allowing differentiation of the atrophy of the non-demented elderly atrophy. CT of brain can exclude an expansive intracerebral process, a hydrocephalus or vascular dementia. Cerebrospinal fluid is normal.
Alzheimer’s Disease Treatment
Currently there is no treatment to slow the evolution of lesions.
Drug treatment of cognitive symptoms is differentiated depending on the severity of the dementia syndrome:
- In mild or moderate forms are used as long-term therapy: cholinesterase inhibitors: rivastigmine, galantamine.
- In severe forms Memantine is the first choice.
- It may be used cerebrolyzin and tanakan (standardized extract of ginkgo biloba).
- Is recommended the treatment of vascular risk factors (antiplatelet, antihypertensive, statins).
Drug treatment of non-cognitive symptoms of dementia is recommended for cases accompanied by psychiatric symptoms (psychotic symptoms, depression, restlessness, sleeplessness).
Non-pharmacological therapy is administered in conjunction with drug therapy in mild and medium forms of dementia. Consists of cognitive workouts, psychomotor exercises, social or occupational therapy. In medium and severe forms, patients need permanent companion and in severe forms they should be hospitalized in specialized medical institutions because the loss of autonomy, as well as many medical complications that may occur.