An 80-year-old chronic alcoholic was diagnosed with atrial fibrillation five years ago. His son describes a stepwise decline in his father’s overall memory over these years. On examination, he is having pseudobulbar affect with brisk DTR in left upper extremity and up-going plantars. What is the diagnosis?
Correct Answer: Multi-infarct dementia
Description: Chronic alcoholism leads to development of dilated cardiomyopathy and atrial fibrillation. The emboli from the hea can lead to multi small infarcts in the brain. This leads to development of a Multi-infarct dementia. Binswanger's disease Long-standing hypeension and atherosclerosis. Associated with diffuse subcoical white matter damage. Vitamin B12 deficiency In the setting of alcoholism will lead to the development of myelopathy involving dorsal column. Dementia seen is subcoical.
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