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Table 185-1

Differential Diagnosis of Dementia

Most Common Causes of Dementia

Alzheimer's disease

Vascular dementia

 Multi-infarct

 Diffuse white matter disease (Binswanger's)

Alcoholisma

PDD/LBD spectrum

Drug/medication intoxicationa

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)

a Potentially reversible dementia.

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