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Pick's disease
May be deprecated term for frontotemporal dementia.
Epidemiology:
-> 5th-7th decade of life
Pathology:
1) lobar atrophy of temporal &/or frontal lobes
-> may involve basal ganglia
2) atrophy is generally symmetric, but may be asymmetric
3) gliosis
4) neuronal loss
5) Pick bodies
6) amyloid plaques may be present
7) neurofibrillary tangles may be present
Genetics: reported cases of autosomal dominant familial disease
Clinical manifestations:
1) cognitive impairment -> slowly progressive dementia
2) behavior disturbance
a) hyper-oral behavior
b) bulimia
c) emotional disinhibition
d) irritability
e) persistent aimless wandering
f) personality changes
3) language disturbance
a) aphasia
b) forced repetitive speech patterns
c) echolalia in later phases
d) mutism with severe disease
Laboratory:
1) see dementia
2) autopsy confirms diagnosis
Radiology:
-> neuroimaging (CT or MRI) shows lobar atrophy of temporal &/or frontal lobes
Differential diagnosis:
-> difficult to distinguish from Alzheimer's disease
Management:
-> no specific treatment
Interactions
disease interactions
General
frontotemporal dementia; frontotemporal lobar degeneration; frontotemporal neurocognitive disorder (FTD, FTLD)
Properties
PATHOLOGY: Pick body
atrophy
ANATOMIC-STRUCTURE: frontal lobe
temporal lobe
References
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 2352
- Miller BL et al
Case 9-2015 - A 31-Year-Old Man with Personality Changes
and Progressive Neurologic Decline.
N Engl J Med 2015; 372:1151-1162. March 19, 2015.
PMID: 25785973
http://www.nejm.org/doi/full/10.1056/NEJMcpc1409839
- NINDS Frontotemporal Dementia Information Page
https://www.ninds.nih.gov/Disorders/All-Disorders/Frontotemporal-Dementia-Information-Page
Databases & Images
OMIM 172700
images related to Pick's disease