Alzheimer's disease - disease of the brain, usually occurring after age 50 and is characterized by a progressive decline in intelligence, memory impairment and personality changes.
Distinguish early (up to 65 years - type II) and later on (after 65 years - Type I) disease onset. Diagnosis is based on clinical presentation, after exclusion of all similar diseases. The diagnosis is confirmed at autopsy by determining the number of senile plaques and neurofibrillary tangles.
Causes
It is believed that the basic value in the occurrence of Alzheimer's disease is a genetic predisposition
Defects in approximately 50% of patients found mitochondrial DNA (502 500, MTND1 gene mitochondrial inheritance). Early onset is associated with defects in the APP gene, PSEN1, PSEN2.
The disease can be treated as a family of diseases that have different origins, but a common pathogenesis: all known gene defects modify the processing of amyloid precursor protein (hypothesis "chain amyloid"), which leads to the appearance of neurotoxic forms proteins.
In Alzheimer's disease in the brain tissue formed numerous plaques - deposits of amyloid protein, causing the degeneration of neurons and their processes.
Symptoms of Alzheimer's Disease
With the development of Alzheimer's disease are observed following diagnosing symptoms:
- Characterized by a gradual onset and progressive course
- Memory disorders.
- Reduced intelligence
- Violation of abstract thinking (concrete, stereotyping, reduction of judgments)
- Violation of higher cortical functions (disturbance of speech, writing, reading, numeracy, learning objects)
- Reducing the criticism to his mental condition. At the critical ratio is partially preserved early stages of the disease, resulting in possible development depression, Suicidal tendencies
- personality changes
- Disorientation in time, place, self (seen in the early stages of the disease)
- Psychomotor agitation in the form of anxiety, restlessness, nervousness, restlessness
- Sociolabor maladjustment
- Exception somatic diseases involving dementia
- Lack of communication disorders with some other mental illness
- The disease may be accompanied by delusions, hallucinations
- Possible late symptoms - convulsions, muscle cramps
Diagnostics
research methods for diagnosis of Alzheimer's disease:
- Blood (detailed clinical and biochemical blood tests, vitamin B12 and folic acid)
- Study of thyroid function
- Von Wassermann reaction and a blood test for HIV
- ECG
- EEG - diffuse deceleration signal
- CT, MRI - atrophy of the cortex, the increase in ventricular cavity. exclude hydrocephalus, Heart attacks, bruises, tumors
- Determination of high content of amyloid in the cerebrospinal fluid
- Excessive dilation of the pupils when administered mydriatics
- Determination of a defective allele E4 ApoE gene.
Alzheimer's Treatment
Specific treatment of Alzheimer's disease at the moment. It should use the minimum number of drugs due to the poor tolerability:
- Ipidacrine 10- 20 mg 1-3 p / day. The duration of a course of treatment - at least 2 months
- Selective inhibitors of neuronal serotonin (fluoxetine, sertraline, trazodone)
- Modulators glutamatergic system (memantine 10 mg p 2 / day for two months)
- Cerebrolysin 5-10 mL / in for 20-25 days
- Antipsychotics (phenothiazine derivatives or butyrophenone) - with delusions and hallucinatory disorders. Treatment starts with minimal doses, gradually increasing to effective
- Carbamazepine 100 mg 2 3 p / d when expressed excitation and aggression
- It should appoint antihistamines
This article used materials medical encyclopedia