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Confusion et Démence

QuestionAnswer
Maladie d'Alzheimer (1ère cause de démence) --> accumulation protéine B-amyloide en amas extra cellulaire = plaque amyloide --> accumulation anormale dans les prolongations neuronaux de protéines "TAU" hyper phosphorylées --> atrophie hippocampe (echelle de Scheltens)
Maladie d'Alzheimer clinique - trble consolidation en mémoire épisodique (atteinte du stockage) - syndrome aphaso-aparaxo-agnosique --> démence sévère = hallucination
Causes organiques de confusion évolutif - hypothyroidie - carence B12 et Folate - syphilis / VIH - tumeurs cérébrales - Hydrocéphalie à pression normal (tble marche + sphincter + cognitifs) - hématome sous duraux chronique - HTA ; diabète - encéphalopathie subaiguë
Démence frontale : svnt maladie héréditaire autosomique dominante - IRM : atrophie cortex frontal - signes clinique vers 50ans - perte de convenance sociale - trble conduite personnelles - perte d'interêt pour les autres - apathie - anosogosie - trble moteurs : astasie-abasie frontale (marche pieds collés)
Démence cortico-sous corticale : Démence à corps de Lewy = Démence + Sd Parkinsonien + hallucinations précoces
Confusion : causes métaboliques - Hypo OU Hyper natrémie - Hypo Kaliémie - Hyper Calcémie - Hypo glycémie - insuffisance surrénale aiguë - hypo thyroïde - Carence B12 ; folates
CAT face à une confusion - prise de sang - ECG - radio thorax
Created by: 2338221822996275
 

 



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