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Washington University Experience | NEURODEGENERATION | Hippocampal Sclerosis of Aging | 1A0 Case 1 History
Case 1 History ---- This 77- year-old right-handed man first developed cognitive impairment with difficulties with executive function at age 68. He became more withdrawn, interacting less socially. At age 70, he developed slower walking and some imbalance. He tended to propulse or fall forward. At age 71, he tended to drag the right foot when walking. He was slower rolling in bed and arising from chairs. At age 72, he had right hand resting tremor. His handwriting became smaller. He became suspicious in his thinking by age 73. Cognitive impairment interfered with activities of daily living – he was clearly demented at this point. He developed erectile dysfunction and urinary incontinence without a sense of needing to urinate. He began screaming and sometimes kicking in his sleep. Levodopa reduced and stopped his tremor but had marginal benefit on walking without improvement in thinking. Higher doses of levodopa reduced falling and his balance seemed to improve. Quetiapine reduced some of the suspicious thinking. At age 73-74 he did have impulse control problems with inappropriate sexual behaviors as well as hallucinations/delusions. He did not have depression. In September 2015, he was found to have widespread metastatic presumed GI adenocarcinoma to the liver, lungs and bone. He died in November 2015 due to respiratory arrest secondary to lung metastases.
