Dementia of infectious origin

Dementia in AIDS

 * HIV is a neurotropic virus
 * immunity is failing
 * occurs relatively long after the primary infection

Prion dementia

 * the resulting spongiform encephalopathies are caused by prions

Kuru

 * spreads by cannibalism → ingestion of raw brain or liver
 * symptoms:
 * progressive, global dementia
 * neurological symptoms – "cerebellar ataxia"

Creutzfeld-Jacobo disease

 * CJD is the most common prion dementia in humans
 * symptoms:
 * the clinical picture matches the picture of kuru':
 * cerebellar ataxias
 * epileptic seizures
 * myoclonus
 * on EEG high sharp waves

Bovine spongiform encephalopathy

 * BSE, or the so-called ''mad cow disease'

Dementia in Lyme boreliosis

 * symptoms:
 * mostly just milder dementia, with a secondary neurasthenic syndrome

Progressive paralysis

 * = tertiary lues
 * at the turn of the 19th and 20th centuries, half of psychiatric patients reportedly suffered from this disease
 * it led to death within 3–5 years
 * English abbreviation GPI (general paralysis of the insane)
 * chronic panencephalitis
 * atrophy of the cerebral cortex
 * infiltration by plasma cells and proliferation of microglia, neurons degenerate
 * is very rare today

Clinical picture

 * first stage - picture of neurasthenic syndrome:
 * fatigue
 * distractibility, nervousness, lability
 * changes in character, neglects duties and appearance
 * rude joking, boasting
 * euphoria to mania
 * there is rapid memory loss with amnestic disorientation
 * antisocial and paraphilic behavior, alcoholism, criminal activity
 * neurological symptoms:
 * hearing disorder - pressure sores, hyperreflexia, pronunciation disorders
 * Argyll-Robertson's pupils - preserved convergence, but no reaction to light
 * sudden death – ictus paralyticus

Forms

 * megalomaniac form – grandiose delusions
 * depressive form
 * simplex form – a picture of progressive dementia
 * Lissauer's form – neurological symptomatology
 * CSF paralysis – finding in the CSF, without clinical manifestation

Diagnosis

 * seropositivity:
 * it is necessary to do "treponemal reactions" (TPHA, TPI), RRR and VDRL, in the tertiary stage they tend to be negative

Treatment

 * year 1917: Wagner – Jeuregg:
 * discovered that "treponemas die at temperatures above 38.5 °C''
 * thats how pyrotherapy was developed = treatment of malaria
 * he received a Nobel prize for his discovery
 * today only ATB - 'penicillin* disease is practically reversible

Related articles

 * Dementia