Multi-infarct Dementia :
When a decrease in the supply of blood to various small portions of the brain damages the ce;;s in those areas then Multi-infarct Dementia results. A rise in the blood pressure damages small capillaries and small clots are formed in these capillaries, which results in lowering of the blood supply in certain parts of the brain.
This disease can start abruptly or may slowly progress. Initially, memory loss (especially the memories of the recent events) takes place. The symptoms tend to fluctuate. Insight into the disease remains relatively preserved. Individual characteristics of the patient still remain more or less intact. But as the disease progresses, the condition of the patient deteriorates substantially. This can also be accompanied by paralysis, depending upon the location of the infarcts.
A perfect and confirmed diagnosis can be made on the basis of symptoms as well as CTScan, MRI and MRAngio. Therefore, the diagnosis is much easier compared to Alzheimer’s. The lipid profile, Doppler of the blood vessels of the neck, 2D Echo of the heart etc are the tests which are specially helpful in the detection of the disease.
Along with the drugs for thinning of the blood, regulating blood pressure and diabetes strictly, maintaining discipline in eating habits and regular exercise are very essential to prevent this disease. In short, this is largely a preventable disease.
· The daily routine should be set in such a simple way, that the patient can remain as independent as possible Similarly, steps should be taken for protection of the patient.
· If required, the patient should be helped in his day-to-day activities like taking bath, wearing clothes and eating.
· The patient’s troubles can be lessened by using methods that help him in remembering things, like maintaining a diary.
· It is essential to keep having conversations with the patient so as not to hurt his/her feelings.
· The schedule of the patient should be easy to follow. Besides, latest medicines like Rivastigmin, Donepezil,Antiplatelet drugs, etc. can be prescribed accordingto the cause of the disease.
It is a matter of debate whether healthy close relatives (daughter, son, sister, brother) of people suffering from Alzheimer’s dementia or others (which are hereditary) should get themselves examined as a precautionary measure. In some countries such facilities are available where genetic investigations can accurately predict the possibility of a person suffering from this disease in future.
Sometimes, symptoms similar to dementia can also be seen in severe mental stress or depression. This is known as Pseudodementia. Appropriate neurological tests can be used to detect this disorder. Its treatment is, comparatively simpler. This can be controlled and there are no long term or aggravating symptoms.
In many other diseases also, some level of memory, behaviour and individual characteristics can get affected. In many such cases, Alzheimer’s disease is wrongly diagnosed, for example, Hypothyroidism, vitamin deficiency, and many collagen diseases like S.L.E etc.
Appropriate drugs are used according to the cause of the disease.
i. Antiplatelet and vipocentin: In vascular dementia.
ii. Drugs of the Ergot group like - Sermion, Hydergine, Cereloid.
iii. The special new drugs like Rivastigmin, Donepezil, Tacrine, Galantamine etc. can be given in Alzheimer’s dementia.
iv. Piracetam for e.g. Normabrain, Nootrophil, Cerecetam or Encephabol.
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