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Follow up question on MS Dementia. What type of testing

should be done on a...
Follow up question on MS Dementia. What type of testing should be done on a patient 69 yr. old female with MS for 50 years who is now developing dementia. Should a baseline be established and what type of follow up
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Answered in 5 minutes by:
9/16/2017
Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Neurology
Satisfied Customers: 9,933
Experience: Experience of Neurology of over 4 years, well versed in EEG, NCS and EMG alongwith MRIs and CT scans
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Hi,
Welcome back, actually in this situation first off a MRI should be done again, this will allow us to determine have any changes occurred since the last MRI and whether those changes are consistent with dementia or MS. Secondly, the dementia should be graded on the basis of physical examination and questionarres. These would include the mini mental state examination MMSE or MOCA tests. In addition depression should be ruled out as a cause which can sometimes mimic this problem. This can be done by the geriatric depression scale, Once these are done then the following tests can be considered,

Urinalysis and microscopy

Complete blood cell count

Serum electrolyte levels, including magnesium

Serum chemistry panel, including liver function tests

Thyroid function tests

Serum vitamin B12

Erythrocyte sedimentation rate

Serologic tests for syphilis (or similar)

Chest radiography

Electrocardiography

These can help narrow down the cause for the dementia by excluding most reversible causes for the problem. If a reversible cause is found then it should be treated accordingly. The MRI of the brain would help us to determine if vascular or lewy body dementia are present or if it is another cause.

Regarding follow up it would need to be with the same clinical tests to determine if it is progressing or not.

But yes a baseline should be established.

Do you have any more questions?

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Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: Neurology
Satisfied Customers: 9,933
Experience: Experience of Neurology of over 4 years, well versed in EEG, NCS and EMG alongwith MRIs and CT scans
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