Fast Five Quiz: Dementia Practice Essentials

Helmi L. Lutsep, MD


March 13, 2023

Differential diagnoses for various forms of dementia include deficiencies of vitamin B12, vitamin E, folic acid, or thiamine. Laboratory tests, including a complete blood cell count and urinalysis, are an essential part of the workup for any patient with dementia. American Academy of Neurology recommendations indicate that structural neuroimaging with either a noncontrast CT or MRI is appropriate in the initial evaluation of patients with dementia to detect lesions that may result in cognitive impairment (eg, stroke, small vessel disease, and tumor). AD is a clinical diagnosis. However, ancillary imaging studies and laboratory tests may be used to help exclude other possible causes for dementia.

Workup for Wernicke-Korsakoff syndrome includes CT and MRI. CT can help in the rapid assessment of edema, hemorrhage, mass effect, and stroke. MRI can confirm cases presenting with a suggestive history and stupor or coma; these offer high specificity but poor sensitivity.

During the workup for vascular dementia, cerebral angiography is not routinely performed, although it is sometimes required before carotid artery surgery. It is also useful in cases of possible cerebral vasculitis, as cerebral vessels can demonstrate beading.

Functional brain imaging with PET and MRI is generally used to make the diagnosis of FTD. EEG findings in FTD are commonly abnormal, often showing focal slowing of electrical activity over one or both temporal and frontal lobes. However, functional brain imaging with PET or lobar atrophy on MRI tend to be more specific and clinically useful.

Learn more about the workup for AD.


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