Diagnostic Tests for Pick's Disease
Pick's Disease Tests: Book Excerpts
Home Diagnostic Testing
These home medical tests may be relevant to Pick's Disease:
- Brain & Neurological Disorders: Related Home Testing:
Pick's Disease Diagnosis: Book Excerpts
Diagnostic Tests for Pick's Disease: Online Medical Books
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for more information about the diagnostic tests for Pick's Disease.
APHASIA, APRAXIA, AND AGNOSIA:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
All patients should have a CBC, sedimentation rate, chemistry panel, a VDRL test, and a CT scan of the brain. The CT scan may demonstrate an infarct, a space-occupying lesion, a degenerative disease, or multiple sclerosis. If this is negative, a neurologist should be consulted before ordering MRI or a spinal tap.
If the patient presents with intermittent aphasia, apraxia, or agnosia, an EEG should be done to rule out epilepsy, and a carotid scan should be done to rule out carotid stenosis or carotid plaques with ulceration. Four-vessel angiography may need to be considered, but a neurologist should be consulted before this is done.
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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Aphasia [Dysphasia]:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
If the patient doesn’t display signs of increased ICP or if his aphasia has developed gradually, perform a thorough neurologic examination, starting with the patient history. You’ll probably need to obtain this history from the patient’s family or companion because of the patient’s impairment. Ask if the patient has a history of headaches, hypertension, seizure disorders, or drug use. Also ask about the patient’s ability to communicate and to perform routine activities before aphasia began.
Check for obvious signs of neurologic deficit, such as ptosis or fluid leakage from the nose and ears. Take the patient’s vital signs and assess his LOC. Be aware, however, that assessing LOC is usually difficult because the patient’s verbal responses may be unreliable. Also, recognize that dysarthria (impaired articulation due to weakness or paralysis of the muscles necessary for speech) or speech apraxia (inability to voluntarily control the muscles of speech) may accompany aphasia; therefore, speak slowly and distinctly, and allow the patient ample time to respond. Assess the patient’s pupillary response, eye movements, and motor function, especially his mouth and tongue movement, swallowing ability, and spontaneous movements and gestures. To best assess motor function, first demonstrate the motions and then have the patient imitate them.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Aphasia [Dysphasia]:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient doesn’t display signs of increased ICP, or if his aphasia has developed gradually, perform a thorough neurologic examination, starting with the patient history. You’ll probably need to obtain this history from the patient’s family or companion because of the patient’s impairment. Ask if the patient has a history of headaches, hypertension, seizure disorders, or drug use. Also ask about the patient’s ability to communicate and perform routine activities before he developed aphasia.
Check for obvious signs of neurologic deficit, such as ptosis or fluid leakage from the nose and ears. Take the patient’s vital signs and assess his LOC. Be aware, though, that the patient’s verbal responses may be unreliable, making LOC assessment difficult. Also, recognize that dysarthria (impaired articulation due to weakness or paralysis of the muscles necessary for speech) or speech apraxia (inability to voluntarily control the muscles of speech) may accompany aphasia, so speak slowly and distinctly, and allow the patient ample time to respond. Assess the patient’s pupillary response, eye movements, and motor function, especially his mouth and tongue movement, swallowing ability, and spontaneous movements and gestures. To best assess motor function, first demonstrate the motions and then have the patient imitate them.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Apraxia:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
If you detect apraxia, ask about previous neurologic disease. If the patient fails to report such disease, begin a neurologic assessment. First, take the patient’s vital signs and assess his level of consciousness. Be alert for any evidence of aphasia or dysarthria. Ask the patient if he has recently experienced headaches or dizziness. Then test the patient’s motor function, observing for weakness and tremors. Next, use a small pin or another pointed object to test sensory function. Check deep tendon reflexes for quality and symmetry. Finally, test the patient for visual field deficits.
Be alert for signs and symptoms of increased intracranial pressure (ICP), such as headache and vomiting. If you detect these, elevate the head of the bed 30 degrees and monitor the patient closely for altered pupil size and reactivity, bradycardia, widened pulse pressure, and irregular respirations. Have emergency resuscitation equipment nearby, and be prepared to give mannitol I.V. to decrease cerebral edema.
If the patient is experiencing seizures, stay with him and have another nurse notify the physician immediately. Avoid restraining the patient. Help him to a supine position, loosen tight clothing, and place a pillow or other soft object beneath his head. If the patient’s teeth are clenched, don’t force anything into his mouth. If his mouth is open, protect the tongue by placing a soft object, such as a washcloth, between his teeth. Turn the patient’s head to provide an open airway.
After completing the examination and ensuring the patient’s safety, take a history. Ask about previous cerebrovascular disease, atherosclerosis, neoplastic disease, infection, or hepatic disease. Then assess the apraxia further to help determine its type. (See Apraxia: Causes and associated findings, page 72.)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Aphasia/Dysarthria:
Diagnostic Approach
(Field Guide to Bedside Diagnosis)
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Aphasia:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Check for obvious signs of neurologic deficit, such as ptosis or fluid leakage from the nose and ears. Take the patient’s vital signs and assess his LOC. Be aware, though, that assessing LOC is typically difficult because the patient’s verbal responses may be unreliable. Also, recognize that dysarthria (impaired articulation due to weakness or paralysis of the muscles necessary for speech) or speech apraxia (inability to voluntarily control the muscles of speech) may accompany aphasia; so speak slowly and distinctly, and allow the patient ample time to respond. Assess the patient’s pupillary response, eye movements, and motor function, especially his mouth and tongue movement, swallowing ability, and spontaneous movements and gestures. To best assess motor function, first demonstrate the motions and then have the patient imitate them.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Apraxia:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Perform a neurologic assessment. First, take the patient’s vital signs and assess his level of consciousness. Be alert for any evidence of aphasia or dysarthria. Then test the patient’s motor function, observing for weakness and tremors. Next, use a small pin or other pointed object to test sensory function. Check deep tendon reflexes for quality and symmetry. Finally, test the patient for visual field deficits.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Aphasia [Dysphasia]:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
If the patient doesn't display signs of increased ICP or if his aphasia has developed gradually, perform a thorough neurologic examination, starting with his history. You may need to obtain this history from the patient's family or companion because of the patient's impairment. Ask if the patient has a history of headaches, hypertension, seizure disorders, or drug use. Ask about the patient's ability to communicate and to perform routine activities before aphasia began.
Check for obvious signs of neurologic deficit, such as ptosis, fluid leakage from the nose and ears, or motor impairment. Take the patient's vital signs and assess his LOC. Recognize that dysarthria (impaired articulation due to weakness or paralysis of the muscles necessary for speech) or speech apraxia (inability to voluntarily control the muscles of speech) may accompany aphasia; therefore, speak slowly and distinctly, and allow the patient ample time to respond. Assess the patient's pupillary response, eye movements, and motor function, especially his mouth and tongue movement, swallowing ability, and spontaneous movements and gestures. To best assess motor function, first demonstrate the motions and then have the patient imitate them.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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