Brain scans for diagnosing dementia?

[JustAndy]

Hi there, my sister and I posted a while back about our mother here.

We have been going through the process of trying to get a diagnosis for mum. It's been slow going but we have gotten mum seen by a GP who then referred her to a neurologist. Other professionals (Social Workers, CPNs setc) have become increasingly involved as mum's levels of confusion have gotten worse (following a brief stay in hospital a couple of months ago).

Mandy (my sister) and I have been kinda holding out for the results of a CT scan that was done in July. It's been the only thing keeping us going in some ways, thinking that once we had a confirmed diagnosis people would begin to take Mum's problems more seriously and we would have more of an idea of the kind of level of care she needs both now and longer term.(She currently lives on her own in a sheltered accomodation scheme).

Well today mum phoned to say she'd received the results of the CT scan in the post and that it found no problems and that this means she's fine!

My questions are really ...

a) What are the next steps likely to be? (I'm pretty confident the neurologist won't leave it there).

b) What types of dementia, if any, does a clear CT scan rule out?

c) Are other types of scan likely? EMI or whatever, and what will these be looking for?

 

[Angela]

Hi Andy & Mandy
I am not a doctor, but I will answer your queries to the best of my knowledge.
Diagnosis or not, those involved in assessing Mums ability to care for herself should of be done, you said you had CPN's and S/W's, what have they been doing then?
In actually fact, Mum should not have been allowed home from hospital without being assessed, and from what you have said, a suitable package of care should have been arranged.
In answer to your Q's, and firstly I would have to see the letter for myself to believe it,
It is likely that the Neuro Dr might leave it there if it shows no damage to the brain, but he should refer Mum to another Consultant, such as a Psychartrist, or maybe a Psychologist.
The CT scan only shows signs of some of the dementia, exactly which Im not too sure, but generally a CT is used to rule out certain dementia. Its after a scan that more test can be done to possible make a more clearer diagnosis.
EMI actually means Elderly Mentally Infirm. An MRI scan however is similair to a CAT scan but is more 3d ish, as in it dosent just look at the outside of the brain, I think!
Check back in with the CPN, they should answer these and other queries you have.

 

[JustMandy]

Hi Angela,

With regard to the CPN and SW, they both seem to be doing a fair bit, but she's currently being "managed" by the "physical disability" social worker's team (due to her use of a wheelchair), although there was talk last week of tranfering her care accross to the Mental Health team. They all admit that she has big problems, but until they know how it's likely to progress they seem to be unwilling to make major decisions, eg as to where she lives to give her the most independdence while recognising that she's suffering from some form of dementia at a young age and needs the support that goes with that. We also have the problems associated with mum's denial of the problems that are patently obvious to those around her.

We have at least managed to get the SW to agree to up her home care visits to 7 days a week instead of 5, although it's still only 30 mins a day - but it's much better than nothing.

When um was discharged from hospital following stomach problems the nurse in charge seemed surtprised that hse lived alone and that nothing had been done about ensuring she had care when she left. Too late to gripe about that after the event - we cetainly hadn't anticipated the sudden deterioration in her condition.

Mum read the letter out to me over the phone, and to be honest I believe that more than if she was trying to recall information - she completely mis-understood the consultant psych when she saw him recently and it took a phone call from me to ensure she didn't start driving again! Mum's due to see the psychiatrist again at the end of next month, by which time he'll have the CT results, and the cognitive testing results. Interestingly the neurologist pointed out that there was a slightly lower level of vitamin B12 in mum's blood test and asked her to get herself retested before she sees the neuro at the end of this month.

The neuorologist did say when we saw her 3 months ago that depending on the test resulst she might refer mum to a psychologist for further tests - and I hope she considers an MRI scan too.

I'm sure they used to call the MRI scan an EMI scan in the past - was it designed by EMI?!

(Wonder if Andy's in the process of replying too!)

Thanks for your feedback - it's very much appreciated.

 

[Angela]

Thats been the difficulty then, that Mum is with the Physical team rather then Mental!
I presumed that Mum was with the Mental Health team as I didn't realise that she had physical problems.

Ah, Vitamin B12, or if its more presicely Thiamine and the lack of it, is what has caused my mothers dementia, Korsikoff or Alcohol dementia, as we have discussed in the past. And unfortunately, there is a link between this and Alzheimer's.
If I were you I would like to see my Mum having MORE from the Psychartrist, the Neurologist has done most that could be expected.
Ps You may be disappointed with any other scans that may be given, they only rule out certain things, get the cognitive tests!