Pick's disease is a rare, chronic andProgressive CNS disease, characterized by atrophy of the temporal, as well as frontal lobes of the cerebral cortex with increasing dementia. The disease begins at 50-60 years, although there are later or early manifestations. Women tend to be sick more often than men.
A. The peak in 1892 described the cases of senile dementia, which are intensified by the atrophic process mainly in the temporal and frontal lobes. Similar studies were conducted by A. Alzheimer, H. Lipman, E. Altman. Statements that the cases of the disease described by A. Pick are an independent form, was first noted by H. Richter. Confirmation of this nosological independence of the disease was the pathoanatomical investigations carried out, which showed a number of morphological features of this pathology.
Morphological features include the followingSigns: the limited nature of atrophic changes in the frontal, as well as temporal lobes; Slight or no vascular changes; Prolapse of elements of the nervous tissue in the upper layers of the cortex. Brain; Absence of all signs of the inflammatory process, as well as senile plaques or Alzheimer's changes in neurofibrils; Atrophic changes, transforming into subcortical areas; The frequent occurrence of globular argentophilic intracellular formations, as well as swollen cells.
The atrophic process is unevenly distributed over certain parts of the brain, beginning in typical areas called the centers of wrinkling and atrophy.
The causes of the onset of Pick's disease are nowTime is not set. At the moment, only factors that increase the risk of its development have been identified. The main risk factor is hereditary predisposition. If blood relatives in old age had different types of dementia, then it is necessary to be very attentive and attentive to their condition.
One of the causes of Pick's disease isIntoxication of the body. Long-term exposure to chemicals on the body increases the chance of developing the disease. Anesthesia is also attributed to the causes of the onset of Pick's disease, since it is very difficult for the nervous system to tolerate it. Head injuries, mental illnesses are also a provoking factor of the disease.
Disease Symptoms Symptoms
Pick's disease at an early stage is characterized byProfound changes in personality and signs of the weakening of all types of intellectual activity. Initial manifestations of the disease are insignificantly related to the prerequisites of the intellect: memorization, memory, attention, sensory cognition. This disease has several variants of the course.
Pick's disease with the first option is of little concernAutomated forms of intellectual activity. As the symptoms of the disease increase, the patients' abilities do not change according to orientation in ordinary or in a simple new environment. The disease affects differentiated, as well as complex personal attitudes and attitudes. There is a change in the nature of the patients, productivity is reduced in parallel, as is the flexibility of thinking and the ability to critically evaluate new, complex situations, the ability to comprehend, make consistent conclusions, generalizations or other mental operations is lost.
Disease disease in contrast to Alzheimer's diseaseIs marked by the development of dementia of the intellect. The intellect is affected by the disease from above. Personality changes in the disease are marked by typical symptoms. During the course of the disease, increased sexual desire, disinhibition with the release of cravings prevails, which provokes offenses. In patients there is a developing disappearance of the sense of tact, distance, shame, as well as previous moral attitudes. Patients tend to predominate inadequate euphoria, impulsiveness and expansiveness, along with a decrease in criticism.
This picture of personality changes is characterized byPsevdoparaliticheskim symptom complex, having gross violations in conceptual thinking, namely the ability to generalize, to determine the difference and similarity, there is inability to explain the proverbs. The peculiarity of the clinic is the absence of a memory disorder and orientation. Disease Peak in another version of the current is characterized by a predominance of lethargy, apathy, aspontaneity, inactivity, increased indifference, and emotional outlining. Parallel with this, there is an impoverishment of speech, motor functions, and thinking. Often there is a dependence on the characteristics of personality disorders and localization of the initial atrophic process affecting convex frontal lobes. As a result, the patient becomes lethargic,
, Inactivity, disinhibition, carelessness,Euphoria, pseudoparalytic syndrome. From the history of such patients, it is known that they lose productivity, negligence and negligence occur in the performance of their duties, they launch cases, there is lack of initiative, lethargy, indifference or excitability, as well as senseless gaiety accompanied by foolishness and tactlessness, selfishness, callousness.
These features in behavior cause an impression,That patients have a decrease in memory, they are forgetful, absent-minded. Active attention in patients is reduced and unstable. Directed memory research reveals the relative safety of its reserves. Patients can memorize simple facts that concern themselves, and events that do not concern them do not show interest. A stock of previously acquired knowledge is also noted, but interest in them is usually lost.
Many cases of Pick's disease are noted by the apparentLoss of memory. Patients for quite some time retain a sense of consistency of time and consciousness. Patients know what will happen in the near future and what has been recently. This opportunity to foresee the future, allocates patients from patients with Alzheimer's disease. The increase in progredness is marked by notable manifestations of dementia, a decrease in intellectual capacity for work and the level of intellectual activity, the defeat of all types of memory. As a result, deep dementia develops, marked by impoverishment of mental activity, as well as by activity. Behavior is characterized by frequent stereotypes, which are repeated monotonously according to the pattern. This is more noticeable in speech with repetitive phrases, words.
Pick's Disease Diagnosis
Patients with suspected diseaseThe doctor-psychiatrist examines. The doctor evaluates the current state through a conversation, a general surface inspection. Preliminary examination reveals the inadequacy of actions, as well as the violation of social behavior.
To assess the state of the brain it is recommended to perform such methods: CT (computer tomography), electroencephalography, MRI (magnetic resonance imaging).
Computer tomography makes it possible to obtain high-precision layered images of the brain, as well as to reveal the degree of progression of the process and the most affected part of the brain.
Electroencephalography allows you to catchThe minimum electrical impulses in the brain. All the impulse data is displayed on a sheet of paper as a set of curves. With Pick's disease, we have a thinned cortex, and so the processes in it take place much less, which is shown by the electroencephalogram.
MRI (magnetic resonance imaging) has the same diagnostic significance as computed tomography.
It is important in diagnosing to differentiate the disease from other diseases (Alzheimer's disease, brain cancer, Huntington's chorea, diffuse atherosclerosis).
Peak Disease Treatment
Cholinesterase inhibitors are used in the treatment. These are drugs such as Amiridin, Rivastigmine (Exelon), Reminil (Galantamine), Arisept, and Gliatilin. These drugs in Pick's disease normalize the condition of patients at an early stage of the disease.
A good effect is available from long-term use(Of the order of 6 months) of NMDA blockers (Acathinolmemantine), as well as nootropic drugs (Phenotropil, Aminalon, Nootropil) and Cerebrolysin. Duplication of productive psychotic symptoms is carried out by soft neuroleptics - Teralen, Terialzhen, Clopixol, Chlorprotixen.
Patients with Pick's disease need a constantPsychological support. Patients are recommended to participate in special training that slows the progression of the disease. The outlook for the future is unfavorable. Six years after the onset of the disease, the moral, as well as mental, decay of the personality comes,
And cachexia. Ill for the society becomes completely lost. The patient needs mandatory permanent care or placement in a specialized psychiatric hospital.