Symptoms mimicking dementia in a 60-year-old woman with bipolar disorder: a case report

BMC Research Notes

Gerbrand J Izaks⁴  Rixt F Riemersma van der Lek³  Jeroen J de Vries¹  Maya V van der Ploeg²  Aida T van de Poel-Mustafayeva²  Froukje H Woudstra⁴ 

[1] Department of Neurology, University of Groningen, University Medical Centre Groningen, Internal Postcode AB51, P.O. Box 30.001, Groningen 9700 RB, The Netherlands;Geriatric Psychiatry Clinic, University of Groningen, University Medical Centre Groningen, University Centre for Psychiatry, Internal Postcode AA82, P.O. Box 30.001, Groningen 9700 RB, The Netherlands;Mood Disorders Clinic, University of Groningen, University Medical Centre Groningen, University Centre for Psychiatry, Internal Postcode CC44, P.O. Box 30.001, Groningen 9700 RB, The Netherlands;University of Groningen, University Medical Centre Groningen, University Centre for Geriatric Medicine, Internal Postcode AA43, P.O. Box 30.001, Groningen 9700 RB, The Netherlands

关键词: Neurodegenerative disease;    Bipolar disorder;    Depressive disorder;    Reversible dementia;    Elderly;   

Others  :  1132447
DOI  :  10.1186/1756-0500-7-381

 received in 2014-01-24, accepted in 2014-06-18,  发布年份 2014

【 摘 要 】

Background

Dementia is generally considered an irreversible process of cognitive decline that can be caused by different neurodegenerative diseases. However, in some cases, dementia is caused by a non-neurodegenerative disease, such as an affective disorder. In these cases, the dementia can be reversible. Nevertheless, cognitive symptoms due to an affective disorder are often difficult to distinguish from a depressed mood due to a neurodegenerative disease. Especially in elderly patients with a history of affective disorder, a potentially reversible cause can be missed.

Case presentation

We describe a 60-year-old white woman with bipolar disorder, depressive symptoms, a movement disorder and severe cognitive impairment, in whom a neurodegenerative disease was seriously considered. She was referred to our clinic for further investigation because initial treatment of the depressive episode with antidepressants, mood stabilizers and electroconvulsive therapy (ECT) had not been successful. However, despite extensive evaluation, we could not find evidence for a neurodegenerative disease and the patient mostly recovered after discontinuation of different psychotropic medications and treatment with nortriptyline.

Conclusions

Our case shows that improvement of severe cognitive impairment in individual cases is possible. In our opinion, this underlines the necessity of a careful re-evaluation of the patient’s symptoms at presentation and the course of the disease as well as a critical review of the prescribed medications.

【 授权许可】

   
2014 Woudstra et al.; licensee BioMed Central Ltd.

【 图 表 】

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