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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for dementia in an elderly person

Answered by
Dr.
Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2474 Questions

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Posted on Thu, 25 Aug 2016 in Headache and Migraines
Question: My aunt is 75 years old. She had a deformation in her face left side since she was 7-8 years old. She also has a lot of brown small balls in her back.
I was always informed by my grandma when I was a kid that she was normal and her face deformed after she caught a virus or so.
Her fingers are also curved not straight.
Just last year I came to learn that her case is called "Neurofibromatosis" for which (in such age) no cure is available.
The new observation is that her memory is becoming very short and this is deteriorating by the day!
She forgets whether she ate or not and whether we are day or night!
She is on Neorovit and Veinoroton daily... What can be done for her?!!
doctor
Answered by Dr. Dariush Saghafi 58 minutes later
Brief Answer:
Dementia may be starting...OR...maybe not

Detailed Answer:
Good afternoon. My apologies that your AUNT (though the Patient Profile states MALE? of 50 years of age?) seems to be developing cognitive difficulties as you've described. You should know that there is no known relationship between NEUROFIBROMATOSIS (Either Type I or Type II) or any type of dementing illness.

Therefore, there is nothing to concern oneself about as far as that diagnosis is concerned.

What to do for your aunt is rather straight forward in this case. She must be brought to the attention of a neurologist and perhaps better yet, a neurobehavioral subspecialist who will carry out the necessary testing and imaging studies of your aunt to determine whether she may be suffering from what we generically but somewhat inaccurately refer to as a "reversible cause" of dementia. Once the proper blood work which should include thyroid and vitamin profiles (B12, D, and folate), as well as a CBC, electrolytes, and liver and renal panels have been obtained then, an imaging study should be considered. Since she has NF my recommendation would be an MRI of the brain and I would likely do it with gadolinium contrast even though you've not mentioned anything about hearing problems etc. I would still do it since in my opinion you are killing 2 birds potentially with 1 stone in order to make sure she doesn't have NF2 and to take a look to see if there were any intracranial pathologies such as hydrocephalus (possible NPH) meningiomas, or other problems that could explain the dementing symptoms.

What to DO then, will depend upon what is found in that sort of complete workup. If NOTHING is found that can be addressed from a chemical/metabolic/anatomic perspective then, I would consider neuropsychological testing and following an analysis of the report by the neurologist a decision can be made whether or not your aunt is suffering from an organic dementing illness and if so, likely which type. Or if dementia is not the explanation perhaps there is a psychiatric diagnosis that is appearing to be DEMENTIA MIMICKING because that happens much more frequently than people believe.

That is why it is never a good idea for a doctor to prescribe a patient medicine for dementia no matter how much it LOOKS like Alzheimer's or whichever form of dementia it may look like clinically BEFORE working the patient up fully since psychiatric illness is much better intervened upon by NON-DEMENTIA methods and drugs...obviously, and needs to be identified.....in the same way that patients labeled as PSYCHIATRIC in nature must be ruled out for neurological disease which if found usually has a MUCH DIFFERENT form of intervention or treatment than would've been the case had the doctor just assumed their were purely psychiatric which often happens when patients are being evaluated for pure symptoms of anxiety, emotional extremes, or even "hearing voices" to which most doctors would likely start treating...thereby possible making a mistake on someone who has a growing tumor or other pathology in the head of an organic nature.

If I've satisfactorily addressed your question then, could you do me the kindest of favors by CLOSING THIS QUERY and be sure to include some fine words of feedback and a 5 STAR rating to our transaction if you feel the response has helped you? Again, many thanks for posing your question.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 33 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dariush Saghafi 7 minutes later
Thank you so much. May I just consume 2 more precious minutes and ask you " what is wrong with my inquiry about my mother's sister while I am a 50 years old male"?
doctor
Answered by Dr. Dariush Saghafi 9 minutes later
Brief Answer:
Ahhh....certainly....no big deal

Detailed Answer:
In the upper right corner of the box that I can see on MY WEBPAGE where I answer your question it says....PATIENT PROFILE.

Under PATIENT PROFILE....it asks for Gender and Age. And under those 2 fields it states: MALE and 50.

Therefore, to me as I am reading the preliminary information trying to get an idea of the PATIENT's gender and age which is as you state in your question a 75 year old FEMALE......I look up at the PATIENT PROFILE and it says MALE, 50 years old.

Here is a copy and paste of what I can see in the upper left corner of my answering screen:




Patient Profile

Gender: Male Visited a Doctor: N/A
Age: 50 Medications Tried: N/A


See the little confusion....but no worries......you may not be used to this website...I just mentioned it to be sure that you and I were really talking about a 75 year old woman....seems like we understood the same thing.

Cheers!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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