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Washington University Experience | NEURODEGENERATION | Pick Disease | 4A0 Case 4 History
Case 4 History ---- This 42 year old man first became ill in the fall of 1973 at the age of 39. He experienced some difficulty in memory and difficulty delivering sermons and was let go from his job as a preacher in 1974. Shortly after that time his wife noted gross confusion; he stopped working and, thereafter, remained at home. He was evaluated in the winter of 1974 and, following a discovery of cerebral atrophy, was diagnosed with Alzheimer disease. When seen in the spring of 1974, he was alert, cooperative and pleasant, but very confused. The examination was normal, except for a 1+ snout reflex. His studies at that time showed a negative serology, normal CBC, normal electrolytes and other blood chemistries, except for a low T4. His EEG and EKG were normal, chest x-ray and skull x-rays were normal, also. Review of a pneumoencephalogram showed mild cerebral atrophy. The cisternogram done with Indium 111 DTPA showed a slow flow pattern consistent with cerebral atrophy. Because of the low thyroid function, he was placed on and maintained on Synthroid for the rest of his life. His regression from that point was rapid, so that he remained very confused and became totally demented. His behavior at home was somewhat combative and irritable and, as a result, he was eventually transferred to Jefferson Barracks Hospital, where he remained from the spring of 1975, until his death in December 1976.
