Case of the Month: December, 2011

Submitted by Blake Kightlinger, MD and Alan Waxman, MD.

71 year old female with history of 1 year of progressive forgetfulness. Past medical history includes DM, CAD, HTN, Bipolar, and UTI. The patient denies alcohol or drug use and reports no recent change to medications. Her vital signs are stable and labs including folate and B12 are normal. Neurologic exam reveals that she is alert and oriented to person and place but not time. She is able to follow two-step commands but has difficulty with object naming and recall. She scores a 18/30 on the Mini Mental Status Examination. Head CT only reveals mild age related atrophy and mild scattered white matter disease. The patient ultimately has a FDG-PET Brain scan and a volumetric MRI for evaluation of dementia.

Report of analysis from volumetric MRI.

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Three-dimensional surface images from FDG-PET Brain study.

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Based on the findings of the FDG-PET Brain study the patient has a pattern of metabolic activity consistent with what disorder?

  1. Multi-infarct Dementia
  2. Lewy Body Disease (Parkinson’s Disease)
  3. Alzheimer  Disease
  4. Frontotemporal Dementia
  5. Prion Disease
  6. Normal Pressure Hydrocephalus
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