Senile dementia, or dementia, is a serious pathology that brings a lot of suffering to both the patient and his environment. There are many reasons for its development. One of them is Pick's disease. This disorder refers to disorders of the central nervous system and primarily affects the cerebral cortex. In today's article, we will dwell in more detail on the main manifestations of the disease and methods of therapeutic support.
Medical certificate
Pick's disease is a rare pathology of a chronic nature. It is accompanied by atrophy of the temporal and frontal parts of the brain, dementia. Most often diagnosed in women aged 50-60 years, but men are not bypassed either.
In 1892, A. Peak first began to describe the pathology. Mental retardation in those days was studied by A. Alzheimer, H. Lipman and E. Altman. Pick suggested that the disease he discovered was a manifestation of senile dementia. However, K. Richter refuted his theory. The scientist noted the independent course of Pick's disease and identified morphological changes characteristic of it:
- exhaustion of the temporal and frontal parts of the brain;
- minor changes in vessels;
- loss of areas of nervous tissue in the upper layers of the brain;
- no inflammation, no Alzheimer's neurofibrils;
- presence of spherical argentophilic intracellular formations.
Pathological processes gradually lead to the elimination of the boundary between the gray and white matter of the brain, an increase in the ventricles. Another consequence of the disease is dementia - acquired dementia, characterized by a loss of knowledge and skills. The patient loses the ability to control his own actions, to speak articulately.
Reason for violation
The exact causes of Pick's disease are unknown to science due to its rarity. However, thanks to numerous studies, some patterns have been identified.
For example, the likelihood of such a diagnosis increases several times if close relatives in old age suffered from manifestations of various forms of dementia. Most often, the disease can be traced in brothers and sisters. The second most common cause is intoxication of the body. This category includes anesthesia, which negatively affects the functioning of the brain.
Much less often, pathology develops against the background of injuries and injuries to the head, mental illness. It is suggested that its development may be influenced by age-related changes in the brain under the influence of viruses.
Clinical picture
Already at the initial stages of the development of Pick's disease, changes in the patient's personality, various cognitive disorders are noted. If the personal component is noticeable well, then memory and attention impairments are not pronounced. Relatives of the patient notice a decrease in criticality, a disorder of inferences and judgments.
Symptomatology of the pathology may vary depending on the localization of atrophic disorders. Among its general features, it should be noted:
- indifference and passivity to others;
- state of euphoria;
- speech and motor impairment;
- stereotyping in actions and writing;
- reluctance to speak, misunderstanding of words, impoverishment of vocabulary;
- sexual liberation;
- temporal mental disorders: hallucinations, jealousy, paranoia;
- sluggishness.
Disorder in its development goes through three stages: initial, loss of cognitive functions, deep dementia. Consider each of the stages of Pick's disease in more detail.
The initial stage of the disease
At the initial stage of the disease, patients experience profound personality changes, disturbances in intellectual activity. Pathology always develops in stages and without sudden jumps.
The most obvious symptom of Pick's disease is the disappearance of a critical attitude on the part of the patient to his condition. This indicates a developing dementia of a total nature. At the same time, motor and mental activity decreases, and the suppression of the emotional background progresses.
At the same time, the patient retains his memory, he can easily navigate in space. Due to the growing dementia, there is often an increasedtearfulness and delusional ideas. Headaches are possible, but as the disease progresses, they completely disappear.
Cognitive Loss
In the second stage of the disease, new symptoms are added. For example, expressive speech begins to grow thin. Sometimes it comes down to a few simple phrases. Grammar noticeably worsens.
The decrease in susceptibility to the speech of others is gradually increasing. The patient develops a stereotype. It manifests itself in the form of simple and uniform responses to addressed speech. The patient begins to speak in monosyllables.
In some cases, patients experience weight fluctuations. First, there is a set of body weight, doctors diagnose obesity. Then there is a sharp weight loss almost 2 times. This leads to a violation of the physiological processes in the body, general weakness and exhaustion.
Profound dementia
This stage of the disease is characterized by the appearance of "standing-type turns". They manifest themselves both in writing and in behavior. For example, at the sight of a funeral procession, the patient can join it, reach the place of the future burial. After that, he usually returns home calmly.
Approximately 35% of cases are observed mental disorders in Pick's disease. The third stage of pathology is considered fatal. Progressive deep dementia is characterized by the inability to perform elementary actions and serve oneself independently. Such patients are usually bedridden and immobilized. Death occurs as a result of the development of concomitantinfectious pathologies typical of bedridden patients.
Pick and Alzheimer's disease: differences
The pathology considered in the article has much in common with Alzheimer's disease. Therefore, the doctor needs to know exactly which of the ailments he is dealing with. The distinguishing features of each of the diseases are listed below.
- Pick's illness is initially lost. This is always accompanied by antisocial acts, some degree of childishness. In the case of Alzheimer's disease, the patient only in the later stages of its development loses himself and becomes passive.
- Peak's disease is rarely accompanied by mental disorders. We are talking about crazy ideas, hallucinations and false identification. In Alzheimer's syndrome, all these symptoms are especially pronounced.
- In the case of Peak's pathology, speech impairment occurs in the initial stages, but they are able to read and write. Alzheimer's disease is characterized by late development of speech problems but early onset of impaired writing.
Another significant difference is age. A patient with Pick's disease first sees a doctor at the age of 50. However, Alzheimer's syndrome is almost never diagnosed before the age of 60.
Even at the stage of diagnosis, only a physical examination and a conversation with the patient is not enough for a specialist. Finding differences between the two disorders will require interviewing relatives and close friends.
Diagnostic features
Primary examination of the patient is carried out by a psychiatrist. First, he conducts a conversation and studiesaccompanying symptoms. If antisocial behavior and inappropriate actions are detected, a specialist may suspect Pick's disease. Diagnosis is further based on the following activities:
- CT and MRI. Allow to identify atrophied areas of the brain.
- Electroencephalography. Helps to pick up electrical impulses in the brain. With Pick's disease, there are very few of them, which is noted by the corresponding devices.
It is important to exclude other pathologies that have similar symptoms to the one under consideration. We are talking about Alzheimer's disease, brain cancer, diffuse atherosclerosis and senile dementia.
Principles of Therapy
This disease is quite rare, which makes it impossible for doctors to study it well and create effective drugs for therapy. The principles of treatment for Pick's disease are very similar to those for Alzheimer's disease. To normalize the patient's condition, cholinesterase inhibitors are used ("Reminil", "Arisept", "Amiridin"). A positive effect is observed after prolonged use of Cerebrolysin, NMDA blockers and nootropics (Phenotropil, Aminalon). Relief of psychotic symptoms is possible thanks to antipsychotics.
The patient gradually loses the ability to self-service, so a guardian is assigned to him. This role is usually played by a relative or close friend. The guardian needs to consult with specialized specialists to know the basics of patient care, to be able to adequately respond to what is happening. If the patient's conditionworsens, and close relatives can not cope, hospitalization is recommended.
Life expectancy and prognosis for recovery
Family should be prepared for the fact that Pick's disease is incurable. Life expectancy after confirmation of the diagnosis usually does not exceed 8 years.
The prognosis for the patient himself is disappointing. The disease is progressive. This means that his symptoms will only increase day by day. Relatives should be psychologically prepared for an imminent loss in the family. At the same time, one should try to show patience and understanding for the patient's condition, because most of his inadequate actions are due to pathology.
Some carers are helped by consultations with psychologists and psychiatrists. These specialists help to properly tune in to the upcoming changes in life. Today there are even so-called help groups. In them, people support each other, help to cope with emerging difficulties, share experiences.
