Alzheimer

Causes: deposition of amyloid material in the cerebral cortex lead to cell

death.
Incidence: 1% above 60 years, 40% above 85 years, 10% of the cases
occurs in population below 60 years.
C/P: all clinical picture due to decrease acetyl choline!,
Duration: from start the disease to reach sta"e # is 8$15 years
Sages:
A) Stage 1: in which there is
1) Memory: loss of memory start with recent memory and extend
"radually to the past memory.to ta%e all memory!
2) Mood changes: depression, in ability to do wor%, and loss of
words
3) eha!ioural changes: disorientation for time
") &isturbance of sleep rhythm
#) 'sychotic symptoms
) Stage 2: in which there is
1! (ncrease of the symptoms of sta"e 1
)! *eurolo"ical symptoms
#! +xtrapyramidal symptoms
C) Stage 3:
1! (ncrease of the symptoms of sta"e )
)! ,e"etative state
#! (ncrease memory a-ection
4! (ncontinence for both faecal and urine mainly if patient above 65
years, inability to dress alone
5! &on.t remember any one
6! /inally death may occur
$rt: li%e dementia treatment
1! *o speci0c mana"ement
)! 1ive treatment to delay pro"ression of memory loss as choline
esterase inhibitors which act by increase acetyl choline as rivasti"mine
exelon! 1.5 m" tab 1$# tab2day.
#! Sym%tomatic treatment:
a) &or 'eha!iour distur'ance: haloperidol 5 m"2day or risperidone
1 m"2day
') &or mood distur'ance: antidepressant 334(!
c) &or slee% distur'ance: ben5odia5epine 0.)5 m" at bed time.