Abstract Body

Background and purpose: Rapidly progressive dementias are a heterogeneous group of diseases that present with cognitive, behavioural and/or motor disturbance. A detailed workup is essential since there are treatable causes.

Methods: Descriptive case presentation

Clinical Case: A previously healthy 58-year-old woman presented with episodes of confusion, disorientation and forgetfulness, with a progressive worsening in the previous 6 months. In the past month, she had persecutory delirium and visual hallucinations, with mood swings.

She answered with circumstantial speech, always turning to her son for support and clues when asked direct questions. She denied any health problem. Her mini mental state examination showed problems in all areas but language, with a score of 12 (12 years of schooling). Her laboratory workup and head CT were normal.

She was then seen by Neurology and Psychyatry and was started on medication, assuming a mixed episode in a bipolar spectrum disorder.

She kept worsening for another month and was admitted to the Neurology inpatient department. An extensive investigation was performed excluding reversible causes of dementia. After 2 months she was transferred to a continued care unit, requiring help for most basic daily activities. She died of pneumonia before a definitive diagnosis was reached.

Conclusions: This case is an example of a cognitive disorder that presented in a young patient and required a multidisciplinary approach. However, even with an inpatient investigation, the etiology was never identified after 10 months since the initial symptoms, reminding us of the limitations we still have in current medical care.