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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4883
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Have you ever seen this symptom: Person continually thinks they have seen something befor

Resolved Question:

Have you ever seen this symptom: Person continually thinks they have seen something before ...usually people doing something, like those two guys are always right there with that box or that lady is always in this store with her kids or that guy is always cutting his grass ... These comments are made multiple times a day, even in places she has never been.
Submitted: 12 months ago.
Category: Mental Health
Expert:  Dr. Z replied 12 months ago.

DoctorZ :

Hello I believe I can help you with your question.

DoctorZ :

The symptom you are describing can be linked to multiple mental health disorders, so I would like to ask a few questions to narrow it down for you if possible.

DoctorZ :

When did the person first exhibit this symptom? Does the individuals have any memory issues? Is the individual taking any medications? Are there any other associated symptoms that you think would be relevant that occurred around the same time as the onset of this symptom?

DoctorZ :

By the way the term for this has been called Deja Vu.

Customer: In addition to confabulation, there are significant short term memory issues. She cannot keep track of dates or days of the week. Can't remember appointments. Might forget she saw a movie. She seems to be missing the button that says do this now (and then she thinks she already did it) on tasks like laundry, showering. This said she has great long term memory and is very intelligent which complicates the problem. Think: you know when you run upstairs and then forget why. It's like that on steroids. I think this started a couple years ago, but not really sure when it started vs when we realized. Docs have her on Zoloft but not sure she needs it. They have no diagnosis.
DoctorZ :

Typically with her age, no incidence of seizures, not history of schizophrenia, or dissociation, I would suggest that she may have dementia. Typically the symptoms of short term memory loss, confabulation, and deja vu are early signs of dementia. Now this does not necessarily mean Alzheimer's disorder, as dementia disorders have different levels of severity

DoctorZ :

Early dementia is usually very hard to detect on a PET scan as well

DoctorZ :

Here is a list of early symptoms of dementia for you as well

Customer: We assumed dementia... but what kind?
DoctorZ :

Right now at this point it is too early to tell. It could be Alzheimer's disorder, but it could be another form of dementia as well

Customer: That is the question. I was hoping the déjà vu thing was textbook of something.
DoctorZ :

Although I doubt it is Vascular Dementia or Lewey Body type Dementia.

DoctorZ :

Deja vu is associated with a number of mental health disorders, and is usually seen in Alzheimer's disorder as an early symptom.

DoctorZ :

But she can also have mixed type of dementia, which are quite common and may have symptoms related to Alzheimer's disorder and another dementia as well

Customer: Docs have said she does not have Alzheimer's.
DoctorZ :

Really? Why did they make that determination?

Customer: She doesn't have all the symptoms I guess. They won't even say she has dementia. She is very smart so when you are only with her for 15 minutes you can't tell there is a problem.
Customer: Is it possible to have Korsakov's (sp?) and not be an alcoholic or have an eating disorder?
DoctorZ :

And there in lies the problem, they are only with her for 15 minutes. I think it is too early for the symptoms for them to make a determination that it is not Alzheimer's disorder.

DoctorZ :

Only if she does not get enough thiamine in her system could she develop Korsakoff's Syndrome

DoctorZ :

So conceivable yes you do not have to be an alcoholic or have an eating disorder to develop this disorder, but very very rare

Customer: She had a thiamin deficiency but it is back to normal.
DoctorZ :

Any idea how long the thiamine deficiency was for?

Customer: No, she had a weird confabulation and neighbors took her to the ER. They said there was a thiamin deficiency and gave her pills. She was on those for several months until her levels were normal again.
DoctorZ :

Well thiamine deficiency is also associated with Alzheimer's Disorder too

Customer: When I say pills I mean thiamin.
Customer: It is?
Customer: Tell me more.
Customer: Her geriatric team acts like this is just old age anxiety and Zoloft is all she needs.
DoctorZ :

Yes it is. We do not know the exact reason why the deficiency occurs, but we speculate thiamine dependent enzymes are altered with Alzheimer's disorder. The Thiamine supplements usually provide some mild benefit though especially in early dementia.

DoctorZ :

It could be, I have no evaluated her or have done tests on her. But I actually have a really simple test that you can do on her, give me one second to get you the link

Customer: So could this be too early to see on a scan? What treatment should we be asking for? Aerosept (sp?)
DoctorZ :

Aricept has been shown to improve cognition and behavior with Alzheimer's disorder, but I think most physicians would only prescribe it in the later stages of disorder and not in the early stages because of the side effects. Unfortunately we do not have a lot of treatment methodologies at this time for Alzheimer's disorder, but keeping her mind busy with puzzles and walking with her and keeping her active have been shown to slow the progression of dementia

Customer: Did you send the link?
DoctorZ :

Here is a test that you can do with your mother to help determine dementia

DoctorZ :

Also her is how to calculate the scores

DoctorZ :

A score of 10-26 shows mild-moderate dementia.

DoctorZ :

This test takes around 10-15 minutes to complete

Customer: She loves walking and jigsaw puzzles
DoctorZ :

That is good, that can help her

DoctorZ :

I would suggest seeing a neurpsychologist or neurologist that can do proper assessments on her to help determine her memory abilities.

DoctorZ :

Is there anything else I can assist you with tonight?

Customer: I think they gave her this test, or something similar, but I will do it again.
Customer: How long before Alzheimer's would show up on a scan?
DoctorZ :

Most neurologists know this test, but is a screen. She should get a full battery of neuropsychological tests.

DoctorZ :

That I cannot tell you because the progression of the disease varies from individual to individual

DoctorZ :

For some it moves fast and other it moves slow

Customer: Yes, she has had a ton. She hated it.
Customer: The link between Alzheimer's and thiamine is a new piece for me.
DoctorZ :

Well these are early symptoms she is showing that are typical of dementia, so it is possible the tests may not catch it. They are not as accurate for early symptoms

DoctorZ :

Well I am happy that I gave you some new information

Customer: She has a doc appt tomorrow so this is something to follow up on.
Customer: Thank you.
DoctorZ :

Anytime, I am happy to help

DoctorZ :

My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4883
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Dr. Z and other Mental Health Specialists are ready to help you

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