Perseveration as main symptom in dementia syndrome: case report
DOI:
https://doi.org/10.15448/2357-9641.2015.2.21996Keywords:
Cognition, Dementia, Glioblastoma.Abstract
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.
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References
Perquin M, Diederich N, Pastore J, Lair M-L, Stranges S, Vaillant M, et al. Prevalence of Dementia and Cognitive Complaints in the Context of High Cognitive Reserve: A Population-Based Study. PloS One. 2015;10(9):e0138818.
Kryscio RJ, Abner EL, Cooper GE, Fardo DW, Jicha GA, Nelson PT, et al. Self-reported memory complaints: implications from a longitudinal cohort with autopsies. Neurology. 2014 Oct 7;83(15):1359–65.
Hugo J, Ganguli M. Dementia and cognitive impairment: epidemiology, diagnosis, and treatment. Clin Geriatr Med. 2014 Aug;30(3):421–42.
Mortimer AM, Likeman M, Lewis TT. Neuroimaging in dementia: a practical guide. Pract Neurol. 2013 Apr;13(2):92–103.
Ngo J, Holroyd-Leduc JM. Systematic review of recent dementia practice guidelines. Age Ageing. 2015 Jan;44(1):25–33.
Brown J. The use and misuse of short cognitive tests in the diagnosis of dementia. J Neurol Neurosurg Psychiatry. 2015 Jun;86(6):680–5.
VI Diretrizes Brasileiras de Hipertensão. Arq Bras Cardiol. 2010 Jan;95(1):I – III.
Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJB, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005 Mar 10;352(10):987–96.
Johnson DR, Sawyer AM, Meyers CA, O’Neill BP, Wefel JS. Early measures of cognitive function predict survival in patients with newly diagnosed glioblastoma. Neuro-Oncol. 2012 Jun;14(6):808–16.
Johnson DR, Wefel JS. Relationship between cognitive function and prognosis in glioblastoma. CNS Oncol. 2013 Mar;2(2):195–201.
Possin KL, Filoteo JV, Roesch SC, Zizak V, Rilling LM, Davis JD. Is a perseveration a perseveration? An evaluation of cognitive error types in patients with subcortical pathology. J Clin Exp Neuropsychol. 2005 Nov;27(8):953–66.
Pekkala S, Albert ML, Spiro A, Erkinjuntti T. Perseveration in Alzheimer’s disease. Dement Geriatr Cogn Disord. 2008;25(2):109–14.
Nagahama Y, Okina T, Suzuki N, Nabatame H, Matsuda M. The cerebral correlates of different types of perseveration in the Wisconsin Card Sorting Test. J Neurol Neurosurg Psychiatry. 2005 Feb;76(2):169–75.
Lee JH, Oh ES, Jeong SH, Sohn EH, Lee TY, Lee AY. Longitudinal changes in clock drawing test (CDT) performance according to dementia subtypes and severity. Arch Gerontol Geriatr. 2011 Oct;53(2):e179–82.
Isella V, Rucci F, Traficante D, Mapelli C, Ferri F, Appollonio IM. The applause sign in cortical and cortical-subcortical dementia. J Neurol. 2013 Apr;260(4):1099–103.
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