A text identification: the unexpected diseases behind "bad memory"

"Doctor, my memory is not very good recently.

"Doctor, what should I do, my mother doesn't seem to know her favorite grandson!"

"Doctor, my dad has become very strange recently.

I believe that doctors and friends can always hear patients or their family members say this in clinical work

To learn more about memory disorders, please click the image below to get the full content with one click

Memory impairment is often an early complaint of patients with dementia syndrome.

Before making a differential diagnosis, the doctor's friends must first understand how to diagnose memory impairment

Take a look at the flow chart, the diagnosis must be "open"

Clinically, the doctor's partner can determine whether the patient has memory impairment through the patient's chief complaint, clinical manifestations, and neuropsychological assessment

Figure 1.

A watch in hand, all categories are available

If you want to identify the diseases corresponding to memory disorders, you must first distinguish the different classifications of memory disorders.

Table 1 Classification of memory disorders and their common diseases  ^[1,2] 

After understanding the classification of memory disorders and their common diseases, doctors can make differential diagnoses for different diseases related to memory disorders! The following is a summary of its clinical characteristics and diagnostic points in "Yizhiyuan" ^[3-6] , hoping to help doctors and friends~

Differential diagnosis, see here, very comprehensive

1.
Alzheimer's disease (AD)

AD has a long course of disease, and early cognitive impairment in AD patients is mostly manifested as near memory loss.
The use of Tau protein or Aβ tracer technology in brain positron emission tomography (PET) imaging can help doctors make early diagnosis
.

Click to view the details of "Alzheimer's Disease" diagnosis and more
.

2.
Frontotemporal dementia (FTD)

The early cognitive impairment of FTD patients is mostly manifested as changes in personality and social behavior, among which behavioral abnormalities are the most significant, and some patients in the middle and late stages may have characteristic asymmetric frontotemporal lobe atrophy
.

3.
Progressive supranuclear palsy (PSP)

In addition to the characteristic vertical eye movement disorder and dystonia of the neck and upper trunk, patients with PSP also have cognitive decline, decreased emotional activity, dementia, and poor spatial orientation memory tests
.

Click to see more details on the diagnosis of "Progressive Supranuclear Palsy"
.

4.
Dementia with lewy body (DLB)

DLB patients mostly present with visual hallucinations, which are characterized by obvious fluctuations
.

5.
Parkinson disease with dementia (PDD)

PDD is a series of cognitive impairment manifestations caused by the pathological changes of Parkinson's disease.
It often occurs one year or several years after the onset of PD, and memory impairment shows a slow progression process
.

The movement disorder is obvious
.

6.
Vascular cognitive impairment (VCI)

Cerebrovascular disease and its risk factors can lead to vascular brain damage.
When at least one cognitive domain is damaged, it is called VCI.
It is a relatively common clinical syndrome.
From cognitive impairment to dementia, and some VCI complicated with AD and other diseases, imaging can be used for differential diagnosis
.

Click to view the diagnosis of "vascular cognitive dysfunction" and other details
.

7.
Intracranial infection

Intracranial infections often present with rapidly progressive multi-cognitive domain disorders, such as herpesvirus encephalitis, progressive multifocal leukoencephalopathy caused by papillomavirus infection, Creutzfeldt-Jakob disease caused by prion infection, neurological Accurate and timely pathogenic detection is the key to differential diagnosis of paralytic dementia and AIDS-related dementia caused by syphilis
.

8.
Nutritional metabolic encephalopathy

A history of the primary disease can help in the differential diagnosis
.

9.
Limbic encephalitis

Imaging examinations of patients with limbic encephalitis show high signal lesions in the medial temporal lobe, and the positive serum auto-related antibodies are helpful for differential diagnosis
.

10.
Intracranial tumors

Imaging of the head can reveal characteristic findings of intracranial tumors
.

This article briefly introduces the differential diagnosis of memory disorders.
If you want to know more about the pathogenesis, diagnosis, treatment, prevention and rehabilitation of memory disorders, you can click the image below to get the full content with one click
.

References: [1] Wang Yi.
Dementia and Prion Disease [M].
Tianjin: Tianjin Science and Technology Press, 2016: 29-37.
[2] Wang Yi, Li Bin.
Dementia and Reversible Cognitive Impairment [M] ].
Tianjin: Tianjin Science and Technology Press, 2018: 14-172.
[3] National Health Commission of the People's Republic of China.
Guidelines for the diagnosis and treatment of hereditary multiple cerebral infarction dementia (2019) [J].
Chinese Journal of Practical Rural Doctors, 2021 , 28(3): 5-7,10.
[4] China Dementia and Cognitive Impairment Diagnosis and Treatment Guidelines Writing Group, Chinese Medical Doctor Association Neurology Branch Cognitive Impairment Disease Professional Committee.
2018 Chinese Dementia and Cognitive Impairment Diagnosis and Treatment Guidelines ( V): Diagnosis and Treatment of Mild Cognitive Impairment [J].
Chinese Journal of Medical Sciences, 2018, 98(17): 1294-1301.
[5] Peng Dantao.
Recent International Guidelines and Consensus in the Field of Cognitive Impairment [J].
Alzheimer's Disease and Related Diseases, 2020, 3(3): 174-176.
[6] Cognitive Impairment Professional Committee of Neurology Branch of Chinese Medical Doctor Association, Writing Group of "Guidelines for the Diagnosis and Treatment of Vascular Cognitive Impairment in China".
2019 Guidelines for the diagnosis and treatment of vascular cognitive impairment in China[J].
Chinese Journal of Medicine, 2019, 99(35): 2737-2744.