Perseveration as main symptom in dementia syndrome: case report

Patrick Alexander Wachholz, Paula Yoshiko Masuda


Aims: Describe a case report highlighting the evaluation and interpretation of cognitive deficits in patients with suspected dementia. Case description An elderly aged 64 years, with well-controlled hypertension and diabetes and no history of memory complaints, developed cognitive decline of rapid onset (three months). She was evaluated in a private practice and treated with an anticholinesterase inhibitor, without having been performed a cognitive screening and evaluation by neuroimaging. During comprehensive geriatric assessment we  found significant impairment of attention and concentration, and verbal and motor perserveration. We suspected of frontal-subcortical impairment, associated with rapid cognitive decline, suggesting a frontal/fronto parietal traumatic or neoplastic injury. Neuroimaging and subsequent biopsy confirmed the diagnosis of glioblastoma multiforme. Conclusions: Cognitive impairment of rapid onset and abnormal responses of specific functions can corroborate or increase the level of suspicion for unusual etiologies of dementia. Proper screening or neuropsychological testing, as part of a comprehensive geriatric assessment, can increase the likelihood and accuracy in identifying differential diagnoses.


Cognition; Dementia; Glioblastoma.


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