DEAR DR. GOTT: Some years ago, you wrote an article on Pick’s disease that I misplaced. Can you discuss it once again?
DEAR READER: Pick’s is a rare but permanent form of dementia similar to Alzheimer’s disease. It has a tendency to affect only certain areas of the brain and can affect people as young as 20; however, it is more common in people closer to 55 or 60. People with Pick’s have abnormal substances known as Pick bodies and Pick cells inside nerve cells within damaged areas of the brain.
Tissue in the temporal and frontal lobes of the brain shrink over time and result in impaired thought processes, behavioral changes and difficulties with speech. It’s the early personality changes that allow physicians to differentiate between Pick’s and Alzheimer’s, which ordinarily presents with memory loss. People with Pick’s behave inappropriately, might exhibit an inability to function publicly, be unable to maintain a job, may withdraw socially, have mood changes, and fail to exhibit concern and empathy. They may have difficulty speaking or cannot speak at all, can’t find the right word to say, have coordination problems, increased rigidity and weakness. There may be a problem with urinary incontinence.
Testing to rule out other dementia-related causes might include an EEG, MRI of the brain, CT of the head and neurological examination; however, a brain biopsy is the only test available for an accurate confirmatory diagnosis.
Treatment might include antidepressants or antipsychotic drugs to control mood swings and agitation. Depending on a person’s symptoms and the severity of the Pick’s, a person may require assistance with self-care and personal hygiene. Pick’s will worsen with time, and a patient may become totally disabled in the course of the disease.
Readers interested in learning more about Alzheimer’s can order my Health Report “Alzheimer’s Disease” by sending a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website’s direct link at www.AskDrGottMD.com/order_form.pdf.
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