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Comprehensive and Methodical: Diagnostic and Management Approaches to Rapidly Progressive Dementia

  • Dementia (J Pillai, Section Editor)
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Abstract

Purpose of review The sudden emergence of a change in cognitive abilities or behavior is an important symptom that warrants medical evaluation and may represent the early stages of a rapidly progressive dementia (RPD). To correctly ascertain the cause of RPD in a given patient, the clinician must be methodical and knowledgeable about the range of potential causes and must move forward with supportive treatment, and in some cases empiric treatment, based on clinical features alone.

Recent findings Significant advances in prion disease biomarkers, the molecular features of rapidly progressive Alzheimer’s disease, and new detection of autoimmune limbic encephalitis disease entities have caused a shift in the diagnostic and treatment framework of RPD. Additionally, in the past decade, emerging retrospective data have led to suggested treatments in autoimmune encephalitis that, if instituted early, can protect patients against residual deficits and disease relapse.

Summary Here, we provide an integrative clinical and diagnostic treatment approach that is applicable to the various forms of RPD. We have highlighted the clinical features of selected types of RPD that have experienced advances in the last 10–15 years.

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Authors and Affiliations

  1. Department of Neurology, University Hospitals Cleveland Medical Center, 3619 Park East Drive, Suite 206, Beachwood, OH, 44122, USA

    Supriya Mahajan MD & Brian S. Appleby MD

  2. National Prion Disease Pathology Surveillance Center and the Departments of Neurology, Psychiatry, and Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Brian S. Appleby MD

  3. 3619 Park East Drive, Suite 206, Beachwood, OH, 44122, USA

    Brian S. Appleby MD

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Correspondence to Brian S. Appleby MD.

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Mahajan, S., Appleby, B.S. Comprehensive and Methodical: Diagnostic and Management Approaches to Rapidly Progressive Dementia. Curr Treat Options Neurol 19, 40 (2017). https://doi.org/10.1007/s11940-017-0474-1

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