The evaluation of rapidly progressive dementia

Neurologist. 2011 Mar;17(2):67-74. doi: 10.1097/NRL.0b013e31820ba5e3.

Abstract

Background: Rapidly progressive dementia (RPD) is a unique set of disorders resulting in cognitive, behavioral, and motor decline within 2 years. A variety of etiologies may contribute to RPD including neurodegenerative, inflammatory, infectious, and toxic-metabolic conditions. Jakob-Creutzfeldt disease (CJD) is frequently the most concerning diagnosis on the differential. The challenge for the neurologist is distinguishing prion disease from reversible processes that result in dementia.

Review summary: This review discusses the clinical aspects and the diagnostic workup of RPD. Particular focus is given to both CJD and the potentially treatable inflammatory conditions that may cause a similar presentation. Furthermore, a standardized stepwise approach is outlined for patients presenting with RPD.

Conclusions: Neurologists should adopt a standardized approach to the rapidly presenting disease processes that may mimic CJD in their clinical and radiologic features.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Brain Diseases / diagnosis
  • Brain Diseases / pathology
  • Brain Diseases / physiopathology
  • Creutzfeldt-Jakob Syndrome / cerebrospinal fluid
  • Creutzfeldt-Jakob Syndrome / diagnosis
  • Creutzfeldt-Jakob Syndrome / pathology
  • Creutzfeldt-Jakob Syndrome / physiopathology
  • Dementia / diagnosis*
  • Dementia / pathology
  • Dementia / physiopathology*
  • Disease Progression*
  • Electroencephalography
  • Encephalitis
  • Hashimoto Disease / diagnosis
  • Hashimoto Disease / pathology
  • Hashimoto Disease / physiopathology
  • Humans
  • Limbic Encephalitis / diagnosis
  • Limbic Encephalitis / pathology
  • Limbic Encephalitis / physiopathology
  • Neurodegenerative Diseases / diagnosis
  • Neurodegenerative Diseases / pathology
  • Neurodegenerative Diseases / physiopathology
  • Neurologic Examination
  • Prion Diseases / diagnosis
  • Prion Diseases / pathology
  • Prion Diseases / physiopathology
  • Prognosis

Supplementary concepts

  • Hashimoto's encephalitis