Pick's disease Health Article

Signs and tests

The doctor will ask you about your medical history and symptoms.

Your health care provider might order tests to help rule out other causes of dementia, including dementia due to metabolic causes. These tests can include:

• Assessment of the mind and behavior (neuropsychological assessment)
• Brain MRI
• Electroencephalogram (EEG)
• Examination of the brain and nervous system (neurological exam)
• Examination of the fluid around the central nervous system (cerebrospinal fluid) after a lumbar puncture
• Head CT scan
• Psychological studies
• Tests of sensation, thinking and reasoning (cognitive function), and motor function

A brain biopsy is the only test that can confirm the diagnosis.

Treatment

There is no specific treatment for Pick's disease. Certain antidepressants may help manage mood swings related to Pick's disease, but further research is needed.

Sometimes patients with Pick's take the same medications used to treat other types of dementia, such as medications that decrease the breakdown of the chemical messenger, acetylcholine (anticholinesterase inhibitors), and memantine (Namenda).

In some cases, stopping or changing medications that worsen confusion or that are not essential can improve thinking and other cognitive functions. This may include medications such as:

• Analgesics
• Anticholinergics
• Central nervous system depressants
• Cimetidine
• Lidocaine

It's important to treat any disorders that contribute to confusion. These may include:

• Anemia
• Decreased oxygen (hypoxia)
• Heart failure
• Infections
• Nutritional disorders
• Thyroid disorders
• Psychiatric conditions such as depression

Treating any medical and psychiatric disorders often helps improve mental function.

Medications may be needed to control aggressive, dangerous, or agitated behaviors.

Some patients may need hearing aids, glasses, cataract surgery, or other treatments.

Behavior modification can help some people control unacceptable or dangerous behaviors. This consists of rewarding appropriate or positive behaviors and ignoring inappropriate behaviors (when it's safe to do so).

Formal psychotherapy treatment doesn't always work, because it can cause further confusion or disorientation.

Reality orientation, which reinforces environmental and other cues, may help reduce disorientation.

Depending on the symptoms and severity of the disease, the patient may need monitoring and help with personal hygiene and self-care. Eventually, there may be a need for 24-hour care and monitoring at home or in a special facility. Family counseling can help the person cope with the changes needed for home care.

Care may include:

• Adult protective services
• Community resources
• Homemakers
• Visiting nurses or aides
• Volunteer services

People may need legal advice early in the course of the disorder. Advance directives, power of attorney, and other legal actions can make it easier to make ethical decisions regarding the care of the person with Pick's disease.