| Autor: |
Razafsha M; Neuropsychiatry Clinic, Massachusetts General Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Buch KA; Harvard Medical School, Boston, MA, USA.; Department of Radiology, Division of Neuroradiology, Massachusetts General Hospital, Boston, MA, USA., Vitolo OV; Neuropsychiatry Clinic, Massachusetts General Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Chemali ZN; Neuropsychiatry Clinic, Massachusetts General Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Departments of Psychiatry and Neurology, Massachusetts General Hospital, Boston, MA, USA. |
| Abstrakt: |
We present the case of a 61-year-old retired catholic priest, who was adopted at a very young age, with psychiatric history of anxiety and depression presenting for evaluation of at least 4 year memory loss and word finding difficulties. Over the preceding couple of years his cognitive functions had rapidly declined. As a result, he became dependent on his elderly parents for most of his instrumental activities of daily living including administration of medication, financial management, and driving. He continues to be independent in his personal care. His presentation offered diagnostic challenges due to the interplay of anxiety and cognitive disorders involving both memory and language domains. In addition, he resisted to repeat formal neuropsychological evaluation. At the bedside, his poor effort on testing was often blamed on his severe anxiety confounding the clinical picture. Lack of knowledge of his family history and his childhood development, and unclear premorbid functioning complicated the diagnostic formulation. A differential diagnosis ranging from possible functional cognitive disorder to neurodevelopmental disorder and neurodegenerative disorders will be discussed. |
