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Table 182-1

Differential Diagnosis of Dementia

Most Common Causes of Dementia
Alzheimer's diseaseAlcoholisma
Vascular dementiaPDD/LBD spectrum
Multi-infarctDrug/medication intoxicationa
Diffuse white matter disease (Binswanger's)
Less Common Causes of Dementia

Vitamin deficiencies

Thiamine (B1): Wernicke's encephalopathya

B12 (subacute combined degeneration)a

Nicotinic acid (pellagra)a

Endocrine and other organ failure

Hypothyroidisma

Adrenal insufficiency and Cushing's syndromea

Hypo- and hyperparathyroidisma

Renal failurea

Liver failurea

Pulmonary failurea

Chronic infections

HIV

Neurosyphilisa

Papovavirus (JC virus) (progressive multifocal leukoencephalopathy)

Tuberculosis, fungal, and protozoala

Whipple's diseasea

Head trauma and diffuse brain damage

Chronic traumatic encephalopathy

Chronic subdural hematomaa

Postanoxia

Postencephalitis

Normal-pressure hydrocephalusa

Intracranial hypotension

Neoplastic

Primary brain tumora

Metastatic brain tumora

Paraneoplastic/autoimmune limbic encephalitisa

Toxic disorders

Drug, medication, and narcotic poisoninga

Heavy metal intoxicationa

Organic toxins

Psychiatric

Depression (pseudodementia)a

Schizophreniaa

Conversion disordera

Degenerative disorders

Huntington's disease

Multisystem atrophy

Hereditary ataxias (some forms)

Frontotemporal lobar degeneration spectrum

Multiple sclerosis

Adult Down's syndrome with Alzheimer's disease

ALS-parkinsonism-dementia complex of Guam

Prion (Creutzfeldt-Jakob and Gerstmann-Sträussler-Scheinker diseases)

Miscellaneous

Sarcoidosisa

Vasculitisa

CADASIL, etc.

Acute intermittent porphyriaa

Recurrent nonconvulsive seizuresa

Additional conditions in children or adolescents

Pantothenate kinase-associated neurodegeneration

Subacute sclerosing panencephalitis

Metabolic disorders (e.g., Wilson's and Leigh's diseases, leukodystrophies, lipid storage diseases, mitochondrial mutations)

aPotentially reversible dementia.

Abbreviations: CADASIL, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy; LBD, Lewy body disease; PDD, Parkinson's disease dementia.