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Alzheimer Disease — SCE Neurology MCQ

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HardNeurodegenerative DiseaseAlzheimer DiseaseSCE Neurology

Progressive amnestic and visuospatial decline is accompanied by medial-temporal and parietal atrophy, low CSF amyloid-beta 42 and raised phosphorylated tau. Which diagnosis is most likely?

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Correct answer: E — Alzheimer disease, given the imaging pattern, in this presentation

The best answer is “Alzheimer disease, given the imaging pattern, in this presentation”. The clinical pattern, topographic atrophy and concordant amyloid and tau biomarkers support Alzheimer disease. “Behavioural-variant frontotemporal dementia” is a credible alternative elsewhere, but it fails the decisive discriminator in this case. “Dementia with Lewy bodies” is a credible alternative elsewhere, but it fails the decisive discriminator in this case. “Normal-pressure hydrocephalus” is a credible alternative elsewhere, but it fails the decisive discriminator in this case. “Subcortical vascular cognitive impairment” is a credible alternative elsewhere, but it fails the decisive discriminator in this case.

Reference: NICE NG97 dementia recommendations: https://www.nice.org.uk/guidance/ng97/chapter/Recommendations