Not seen in Alzheimer’s Disease?
Correct Answer: Ventricular shrinkage
Description: Ans. is 'b' i.e., Ventricular shrinkage [Ref: Harrison's 19th/e p. 2598-99 & 18th/e chapter 371o MRI in Alzheimer's disease does not demonstrate ventricular shreinkage or Atrophy.o MRI in Alzheimer's disease demonstrate: -# Hippocampas atrophy# Posterior predominant cortical atrophy.o Topographical distribution of neurofibrillary tangles in Alzheimer's disease# Entorhinal cortex - hippocampus# Limbic and temporal cortical areas# Association areas of the neocortex.Various neurological abnormalities are seen in Alzhiemer's disease.o The sequence of neurological disabilities may not follow any described order and one or another deficit may take preceedence but usually the disease preceedes in the following four observed patterns.Korsakoff amnestic stateGradual development of forgetfulness is the major symptomo Small day to day happenings are not rememberedo Seldom used names are particularly elusiveo Little used words from an earlier period of life also tends to be lost.o Appointments are forgotten and possessions misplaced.o Questions repeated again and again.o Once the memory disorder has become pronounced', other failures in cerebral function become increasingly apparent.Dvsnomiao Patients speech is halting because offailure to recall the needed wordo The same difficulty interrupts writingo Vocabulary becomes restricted and expressive language becomes stereotyped and inflexibleo The range of vocabulary and accuracy of spellings are reduced.o Repetition of every spoken phrase (echolalia)o Deterioration of speech ultimately progresses to anomic aphasiao Fault in balancing the checkbook ultimately progresses to a point where the patient can no longer carry out simple calculations (acalculia or dyscalculia)Visuospatial orientation becomes defectiveo Cars cannot be parked; the arms do not find the correct sleeves of the jacket or shirt.o Prosopagnosia (impaired facial recognition). Difficulty in recognizing familiar faceso The patient forgets how to use common objects and tools while retaining the necessary motor and coordination for these activitie (Apraxia)Paranoia and other personality changeso Restlessness and agitation occurs later in the diseaseo Paranoid delusional state and hallucinations may occuro Depression
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