CC BY-NC-ND 4.0 · J Neurosci Rural Pract 2017; 08(S 01): S66-S71
DOI: 10.4103/jnrp.jnrp_100_17
Original Article
Journal of Neurosciences in Rural Practice

Syndromes of Rapidly Progressive Cognitive Decline-Our Experience

Sadanandavalli Retnaswami Chandra
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Lakshminarayanapuram Gopal Viswanathan
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Anupama Ramakanth Pai
1  Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Rahul Wahatule
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
,
Suvarna Alladi
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
› Author Affiliations
Further Information

Publication History

Publication Date:
03 September 2019 (online)

ABSTRACT

Background: Dementias are fairly slowly progressive degenerative diseases of brain for which treatment options are very less and carry a lot of burden on family and society. A small percentage of them are rapidly progressive and mostly carry a different course outcome. However, there are no definite criteria other than the time line for these patients. Aims: The aim of this was to identify and categorize the causes and course of rapidly progressive dementias seen in our center. Settings and Design: Patients who presented with rapid deterioration of cognitive functions within weeks to 1 year between 2011 and December 2016 were evaluated. Patients and Methods: All patients underwent all mandatory tests for dementia including brain imaging. Complete vasculitis workup, autoimmune encephalitis profile including Voltage Gated Potassium Channel, N-methyl-D-aspartic acid receptor, glutamic acid-decarboxylase, thyroid-peroxidase antibody, cerebrospinal fluid, and other special tests such as duodenal biopsy and paraneoplastic workup were done based on clinical indications. Results and Conclusions: Out of 144 patients 42 had immune-mediated encephalopathy, 18 had Creutzfeldt-Jakob disease, 3 had Vitamin B12 deficiency, 63 had infection with neurocysticercosis, 7 had tuberculosis, 2 had HIV, 1 had herpes simplex encephalitis, 1 had neurosyphilis, 1 Whipples disease, 1 had Subacute Sclerosing Panencephalitis, 1 had Mass lesion, 3 had Frontotemporal dementia, and 3 had small vessel disease. Good majority of these patients have infective and immune-mediated causes and less number belong to degenerative group. Therefore, caution is needed to look for treatable cause as it carries a different treatment options and outcome.