Reversible Causes of Cognitive Decline

AA

Infectious Causes

HIV– Seen in 5-15% of AIDS pts– HAART (particularly zidovudine)

Syphilis– Meningovascular, Tabes Dorsalis, Paretic Neurosyphilis,

Gummas– Tx: Penicillin G, Doxycyclin + Ceftriaxone

HSV-1– Causes necrosis of frontal and temporal lobes– Tx: Vidarbin and Acyclovir (ASAP!!)

Metabolic Causes

Hypothyroidism– Decreased metabolism and decreased effect of

catecholamines.– Tx: Levothyroxine

Renal Failure– May result in NT deficit; PTH may have negative effect– TX: Dialysis or Renal Transplant

Hepatic Failure– Tx: Transplant

Metabolic Causes

B12 Deficiency– Particularly bad effect on memory– Needed for health and maintenance of myelin– Often seen in Alcoholics– TX: Vitamin Substitution

Genetic

Metachromatic leukodystrophy (MLD) – AR deficiency of enzyme arylsulfatase – Abnormal storage of sulfatides and demylination– TX: Bone Marrow Transplantation

Pressure

Normal Pressure Hydrocephalus

Brain Tumor

Subdural Hematoma

Drugs and Toxins

Solvents & Heavy Metal Dusts/Fumes (ex. Lead, Copper)– Have direct toxic effect on brain cells

Drugs– Perscription: Sleeping Pills, Tanquilizers,

Anticholinergics– Illicit : esp. Cocaine, Heroin

STEPS