What is Pick’s Disease?
Pick’s disease is another rare condition which is a form of dementia. Sometimes this is associated with frontotemporal dementia, meaning there is involvement of the frontal and anterial lobes of the brain. This is primarily caused by the shrinking of the brain cells, making protein buildup as the culprit for this disease. Sometimes this condition is confused with Alzheimer’s disease, but we can clinically determine the difference between the two. Since the condition is involved with memory loss, there are times we are confused with the two conditions. But a difference in symptoms can make these two distinct from each other.
This condition has distinguishing features to readily diagnose it. The onset is before the age of 65. There are personality changes right before memory loss is presented. Loss of normal controls and inhibition is observed such as food intake, sexual satisfaction and attention.
Pick’s Disease Symptoms
As this condition is usually confused with Alzheimer’s disease, the very distinction is the first onset of personality changes with Pick’s disease. Misconception is common among those who do not know the condition. Those affected with this disease is usually inappropriate in their behaviors. They tend to behave the wrong way in social settings. These behavioral changes tend to worsen and are considered the most troubling symptom of the disease. Decision making skills are altered thus making them incompetent in doing complex tasks and in understanding written or oral language.
The following below are the general symptoms of Pick’s disease:
Behavioral changes
- Impulsivity and poor judgment
- Extreme restlessness
- Inattention/problems to maintain good hygiene
- Overeating or excessive drinking
- Sexual promiscuity
- Decreased interest in activities of daily living
- Repetitive/ obsessive behavior
- Inappropriate behavior
- Lack in interest to keep job
- Inability to interact in social situations/ withdrawal to social interactions
Emotional changes
- Sudden mood changes
- Lack of empathy
- Apathetic
- Rude, impatient and aggressive
- Poor attention span
- Failure to recognize changes in behavior
- Lack of care about events and environment
Language/speech changes
- Mutism (ability to speak is not attained)
- Loss of vocabulary or finding the right or appropriate word
- Difficulty speaking or understanding speech (aphasia)
- Repeating words others say (echolalia)
- Week speech sounds
- Unable to read or write
- Complete loss of speech
Neurological changes
- Memory loss
- Movement and coordination difficulties
Physical changes
- Muscle rigidity
- Difficulty moving
- Weakness
- Urinary incontinence
In order for the doctor to diagnose a client to have Pick’s disease, symptom evaluation is needed along with brain scans. With the presenting symptoms, we can back it up with the scans results making a clear differential diagnosis. This can also make us put aside other possible diagnoses from the different forms of dementia.
Medical assessments such as brain MRI, electroencephalogram, neurologic exams, cerebrospinal fluid exam, head CT scan and tests of sensation, thinking and reasoning and motor function are just some of the procedures/tests done to patient’s suspected of this type of dementia. A brain biopsy is the only confirmatory test of the diagnosis.
Pick’s Disease Causes
Like most conditions, the exact cause of this condition is said to be unknown. But as this condition is confirmed through a brain biopsy, it has been found out that there have been abnormal substances inside the nerve cells in the brain. These substances are called Pick bodies and Pick cells. These were thought to contain an abnormal form of protein tau. According to studies, this protein is found in all nerve cells but some sufferers of Pick’s disease have abnormal amount of this protein in their nerve cells.
The exact mechanism of this protein is not yet known to the medical world. Though there are also different genes found to may have caused this condition. Thus making this a hereditary form of disorder. As a rare disease, it can also occur to the young population. But the usual affected people are those aging forty to sixty years old, giving us an average of 54 years.
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Pick’s Disease Treatment
Since the symptoms of this condition can be readily identified, as a medical practitioner we need to find ways in order to resolve them. Symptomatic interventions are preferable for this case. Controlling of the symptoms is a must so not to make the condition at its worst case.
Family members should be well educated with this condition. They need to comprehend the situation that the patient is in so to guide the affected. Providing assistance in patient’s need is a must in the beginning. We need to make sure that the client is safe and is away from harm. Since the patient is impulsive in any way, controlling and behavior modification is tantamount to helping them. Giving out reward systems from positive behaviors can help the client reinforce the appropriate behavior when the manifestations set in. providing the client speech therapy can improve their communication skills. We have to clearly remember that the patient have no complete control to his/her actions. Understanding that the patient’s behavior is from the condition is a must for family members and medical health workers.
Along with all the medical assistance to the patient, we need also provide medications to ease up the presenting symptoms. Antidepressant such as selective serotonin reuptake inhibitors is given to patients to provide relief from apathy and depression, impulsiveness and compulsive & obsessive behaviors.
One important medical intervention to the client is setting out reality or reality orientation. Patients with Pick’s disease can make a person confused with the difference between real and not real. This can help patient in reducing their disorientation.
In the beginning, we need to help patient doing self-care activities. It is important that we do not do it for them; instead we just need to assist them in completing their tasks and hopefully letting them gradually do it with supervision.
Pick’s Disease Life Expectancy
This is a progressive disease, making the patient totally incapable and disabled. Assistance is quite necessary for to make things better for the patient. When a patient is diagnosed with this condition, his/her life expectancy is reduced to 2 to 10 years. This is because of the general failure of the body systems.
