Book contents
- Common Pitfalls in Cognitive and Behavioral Neurology
- Common Pitfalls in Cognitive and Behavioral Neurology
- Copyright page
- Dedication
- Contents
- Diseases Discussed in the Book
- Preface
- Acknowledgements
- Abbreviations
- Part 1Missing the Diagnosis Altogether
- Part 2Misidentifying the Impaired Cognitive Domain
- Part 3Missing Important Clues in the History
- Part 4Failure of Pattern Recognition
- Part 5Difficult-to-Characterize Cognitive/Behavioral Disorders
- Part 6Clinical Findings That Are Subtle
- Case 26Something Does Not Look Right
- Case 27Moving without Thinking
- Case 28A Pause in the Clause
- Case 29Seeing beyond Alzheimer Disease
- Case 30“That Is Not How I Feel”
- Part 7Misinterpreting Test Results
- Part 8Attributing Findings to a Known or Suspected Disorder
- Part 9Missing Radiographic Clues
- Part 10Management Misadventures
- Index
- Plate Section (PDF Only)
- References
Case 26 - Something Does Not Look Right
from Part 6 - Clinical Findings That Are Subtle
Published online by Cambridge University Press: 03 November 2020
Book contents
- Common Pitfalls in Cognitive and Behavioral Neurology
- Common Pitfalls in Cognitive and Behavioral Neurology
- Copyright page
- Dedication
- Contents
- Diseases Discussed in the Book
- Preface
- Acknowledgements
- Abbreviations
- Part 1Missing the Diagnosis Altogether
- Part 2Misidentifying the Impaired Cognitive Domain
- Part 3Missing Important Clues in the History
- Part 4Failure of Pattern Recognition
- Part 5Difficult-to-Characterize Cognitive/Behavioral Disorders
- Part 6Clinical Findings That Are Subtle
- Case 26Something Does Not Look Right
- Case 27Moving without Thinking
- Case 28A Pause in the Clause
- Case 29Seeing beyond Alzheimer Disease
- Case 30“That Is Not How I Feel”
- Part 7Misinterpreting Test Results
- Part 8Attributing Findings to a Known or Suspected Disorder
- Part 9Missing Radiographic Clues
- Part 10Management Misadventures
- Index
- Plate Section (PDF Only)
- References
Summary
This 60-year-old woman presented with a 2-year history of cognitive changes and hallucinations concerning for dementia with Lewy bodies (DLB). She first reported seeing a bright moving circle out of her right visual field. The image was always the same and the episodes lasted 20 seconds. Their frequency increased to five times a day over the course of six months. After each episode, she experienced a headache lasting up to an hour with no associated nausea or photophobia. She had been initially diagnosed with migraine with aura and tried propranolol, verapamil and amitryptline, to no avail. Since starting topiramate six months prior to her evaluation the frequency had reduced to about once a day. However, she felt forgetful, slower in her thinking and had difficulty finding words since initiating topiramate treatment. The development of cognitive impairment in the background of hallucinations had raised the concern for early stages of DLB. However, she denied any motor changes (i.e., parkinsonism) or sleep disturbances (i.e., symptoms of REM sleep behavior disorder).
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- Common Pitfalls in Cognitive and Behavioral NeurologyA Case-Based Approach, pp. 83 - 86Publisher: Cambridge University PressPrint publication year: 2020
References
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