Steroid dementia: an overlooked diagnosis?
The authors studied a 72-year-old man with polymyalgia rheumatica who, after taking 100 mg of prednisone for 3 months, developed a psychosis followed by dementia. It was initially considered that the dementia was a separate neurodegenerative condition, probably of Alzheimer type, but when steroids were discontinued, he rapidly returned to his previous level of functioning. Reviewing the literature regarding the effects of steroids on cerebral function, the authors found that such cases of "reversible dementia" are not uncommon, although rarely given the emphasis they deserve. The authors believe, given the extensive use of steroids in medical practice, that physicians should be more aware of this important cause of reversible dementia.
Sacks
Oliver
O
Albert Einstein College of Medicine, Bronx, NY, USA.
Shulman
Melanie
M
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000139:chemically induced*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D003704:Dementia / Q000139:chemically induced* / Q000175:diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D018450:Disease Progression; D062787:Drug Overdose; D005059:Euphoria; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D011111:Polymyalgia Rheumatica / Q000188:drug therapy / Q000523:psychology; D049268:Positron-Emission Tomography; D011241:Prednisone / Q000009:adverse effects* / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D011241:Prednisone