Day Gregory S, Tang-Wai David F
University of Toronto, Division of Neurology, University Health Network Memory Clinic, Toronto Western Hospital, Toronto, ON, Canada.
Neurodegener Dis Manag. 2014;4(1):41-56. doi: 10.2217/nmt.13.75.
Making a diagnosis of rapidly progressive dementia requires practical adaptation of the skills used to assess patients with chronic causes of cognitive impairment. An expedited assessment, commensurate with the accelerated pace of the disease, is required to identify the cause of symptoms amidst a myriad of possibilities. Features upon history, physical examination and cognitive assessment that support specific diagnoses are reviewed, and a stratified approach to testing is presented. The use of readily-accessible investigations is prioritized, acknowledging the implications and applications of novel diagnostic tests. The coordinated use of clinical and laboratory measures are promoted as a means of facilitating rapid evaluation, with the ultimate goal of identifying patients with potentially reversible causes of rapidly progressive dementia.
对快速进展性痴呆进行诊断需要切实运用评估慢性认知障碍病因患者时所使用的技能。鉴于疾病进展迅速，需要进行快速评估，以便在众多可能性中找出症状的病因。本文回顾了病史、体格检查和认知评估中支持特定诊断的特征，并提出了分层检测方法。优先使用易于获取的检查手段，同时认识到新型诊断测试的意义和应用。提倡临床和实验室检查措施的协同使用，作为促进快速评估的一种手段，最终目标是识别出具有快速进展性痴呆潜在可逆病因的患者。
