Vascular dementia as a frontal subcortical system dysfunction.
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Aged↗
Biomedical subjects
J C Looi
Publications and source records attributed to J C Looi.
Differentiation of vascular dementia from AD on neuropsychological tests.
BACKGROUND: The concept of vascular dementia (VaD) is currently in a state of evolution. Memory impairment is emphasized as a primary criterion, reflecting the influence of AD on the concept of dementia. We have systematically reviewed whether the nature of neuropsychological dysfunction is distinct in AD and VaD, and whether similar defining criteria for the concept of dementia in both disorders can be supported. METHODS: We searched five bibliographic databases (Medline, Biological Abstracts, EMBASE, PsychINFO, PsychLIT) for research articles in which VaD and AD had been compared using neuropsychological tests and that met criteria for scientific merit. RESULTS: Of the 45 studies, 18 were excluded because of inadequacies, and the remaining 27 were analyzed. There were a number of similarities of dysfunction between VaD and AD. However, when matched for age, education, and severity of dementia, VaD patients had relatively superior function in verbal long-term memory and more impairment in frontal executive functioning compared with AD patients. Interpretation of the results is limited by uncertainty in diagnostic criteria for VaD, possible inclusion bias due to use of clinical diagnosis alone, possible overlap of AD and VaD, and the methodologic shortcomings of some studies. CONCLUSIONS: The neuropsychological differentiation of VaD from AD was consistent with the different neuroimaging findings in the two disorders, and argues for differential criteria for the definition of the syndromes. The simple application of Alzheimer's dementia criteria to VaD, with the inclusion of cerebrovascular disease etiology, may not be sufficient to capture the uniqueness of VaD.
Alzheimer Disease↗
Vascular dementia: diagnosis, management and possible prevention.
There has been a recent upsurge of interest in the clinical features of and risk factors for vascular dementia, and consensus is emerging on its diagnostic characteristics. We discuss these features and risk factors and the main intervention strategies, both for treatment and prevention.
Dementia, Vascular↗
Munchausen's syndrome presenting as decompression illness.
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Adult↗
Homeless, helpless and hospitalised: the travails of a Chinese refugee.
OBJECTIVE: To report the case of a Chinese refugee who presented with a brief reactive psychosis in the presence of significant stressors. CLINICAL PICTURE: A 30-year-old Chinese refugee, who fled alleged torture and persecution in China, presented with an acute, severe, paranoid psychosis. TREATMENT AND OUTCOME: This patient's psychosis was exacerbated by involuntary hospitalisation and treatment. The withdrawal of restrictive measures, cessation of medications and attention to his social needs led to an improvement in his condition. CONCLUSIONS: Involuntary treatment of a brief reactive psychosis in those who have been previously tortured may exacerbate the psychosis. Withdrawal of restrictions and advocacy for the patient may generate a therapeutic alliance with a positive outcome.
Adult↗
Hyponatremia, convulsions and neuroleptic malignant syndrome in a male with schizoaffective disorder.
OBJECTIVE: The aim of the study was to highlight the diagnostic difficulties occurring when hyponatremia presents concurrently with neuroleptic malignant syndrome (NMS). Diagnostic issues in the differentiation between hyponatremia and NMS are discussed. CLINICAL PICTURE: A case of dilutional hyponatremia (DH) secondary to psychogenic polydipsia (PP) associated with NMS occurring in a male with schizoaffective disorder is described. The clinical picture was complicated by convulsions, perhaps due to clonazepam withdrawal and possible lithium toxicity. TREATMENT: The patient was treated with supportive medical measures. OUTCOME: The patient made a full recovery. CONCLUSIONS: Hyponatremia and NMS have been found to be associated. This association may be due to an undefined common pathogenesis, or may be coincidental. Hyponatremia may also hinder the diagnosis of NMS.
Adult↗