Case number one was an officer on active duty who brought his mentally retarded son to the U.S. Naval hospital in Bethesda, for neurological evaluation. At the time the officer's speech was somewhat hesitant, and his general behavior was inconsistent with his rank. Shortly after this contact he was unable to perform his duties properly. He obtained a job requiring minimal intellectual demands, which he soon had to relinquish. He was restricted from driving a car following an attempt to race a locomotive to a grade crossing. Approximately 12 years after retirement he was noted to pilfer small items when shopping. A rapid progressive decline in his communication abilities followed; he tended to repeat stories and continually drummed his fingers. The following year his writing had deteriorated, and his number abilities consisted only of writing numbers. Within 5 months he could not add 3 + 2, which was written for him, but he did write the number 3 and then 4. When 1 + 1 was written for him, he could only cross the "ones" making them into plus signs. He could hardly write his name correctly, and within months he could not succeed in dividing a circle and a square into 3 equal parts, nor could he copy a vertical zigzag. Five months later he could not copy a straight line or a circle, but he did attempt to copy the letter "M", and to write his name. Shortly after these productions he became mute and vegetative.

Case number two was a previously healthy woman who died at the age at 69 after a 12-year illness. The illness had begun with symptoms of depression, delusions, flat affects, withdrawl, and neglect. Over the next 4 years she deteriorated, becoming incontinent of feces and urine and showing aggressive outburst. She stirred food in her mouth and spat it out. Neurological examinations showed global intellectual deterioration, slight clumsiness and a mild loss of muscular power. She had no spontaneous conversation and answered questions in monosyllables. She also showed notable distractibilities. The patient died of pneumonia following a fractured hip.

Case three was a 56 year old man with a history of acute anxiety attacks for several years, followed by symptoms of depression, loss of memory, restlessness, irritability, social withdrawl, and neglect. He had poor judgment, with loss of insight, memory, and general information. His conversation was limited to the continuous repetition of six phrases. The patient became incontinent and belligerent, and had a habit of putting cigarette butts in his mouth. At the end his right hand had become rigid and flexed, he died at 63 years of age.

Is Pick's Disease Really Alzheimer's?

Pick's disease and Alzheimer's disease have classically been considered to be two distint neurological disorders. Although often clinically indistinguishable, the disorders do hold some differences in cell structures. Alzheimer's disease is characterized by abundant tangles [neurofibrillary] and senile plaques [neuritic] in the cerebral cortex. Pick's disease is characterized by pale, swollen neurons called "pick's antibodies" found throughout the brain, which is highly similar to that of the tangles in AD. Though in most reported cases of Pick's disease, the tangles and plaques found in Alzheimer affected brains, have not been present. Pick's disorder occurs both sporadically and in a genetic form though the genetic form generally has an earlier age onset. The essential characteristics of hereditary dementia is often displayed in a pattern called "dominant inheritance", and there are no known causative or disposing factors, and in particular there is firm evidence against its communicability.

From NORD

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