Mandatory paraclinical examination ...

Compulsory paraclinical examination of patients with dementia · Blood count · blood electrolytes, sugar, creatinine, liver enzymes · Thyroid hormones · level of vitamin B12 and folate in serum · Serological tests for syphilis · CT / MRI of the brain additional paraclinical Survey · HIV tests · Chest X-ray · urine, including by heavy metal salts; · Lumbar puncture · Electroencephalography · · skull X-ray examination of Cardiology - EKG, ECG monitoring, echocardiography · UZDG main arteries of the head. Only a small percentage of cases (an average of less than 15%) can identify potentially treatable or reversible causes of dementia, usually using the above methods. The most important are the following conditions: iatrogenic (caused by medication) encephalopathy, depression, thyroid disease, infections of the central nervous system (such as neurosyphilis or cryptococcal meningitis), vitamin deficiency, structural brain lesions (tumors, etc.). After exclusion of these states are the most likely causes of dementia are Alzheimer's disease or vascular dementia. The most common causes of dementia, Alzheimer's disease · · Vascular dementia · "mixed" dementia (combination of changes characteristic of Alzheimer's disease, with changes of the vascular nature) · Dementia with Lewy bodies · Frontotemporal dementia · "Parkinsonism-plus" (nadyaderny progressive paralysis, cortico-basal degeneration, etc.) · Parkinson's disease Huntington's chorea · · normotensive hydrocephalus · Alcoholism is the medicinal intoxication Alzheimer's disease, related to the primary degenerative dementia, characterized by a progressive decline in cognitive functions, primarily memory, and the development of behavioral disorders. Actually focal neurological symptoms until the later stages of the disease rather scarce - can be detected in patients positive axial reflexes, extrapyramidal disorder. The disease can be complicated by the emergence of emotional-affective and other mental disorders that significantly impedes patient care. Paraclinical methods of investigation in patients with suspected Alzheimer's disease, but rather help to exclude other causes mnestiko and intellectual disorders than confirm the diagnosis. The exception to this, with certain reservations, can be carried out in dynamic MRI of the brain, allowing objectify the increasing atrophy of the temporal cortex and parietal lobes and the hippocampus (with the appropriate clinical) methods of functional neuroimaging, and actively developed in recent methodology for the identification of biological markers this disease. Leading role in the pathogenesis of memory impairment and other higher mental functions in Alzheimer's disease is given to changes of the neurotransmitter systems, especially atsetilholinergicheskoy.