title: Reversible mild cognitive impairment--a case report.
abstract: With an increased general practitioner and public awareness, patients are being referred on to Memory Clinics earlier and Mild Cognitive Impairment (MCI) is often a conclusion of the assessment. The function of memory clinics is to facilitate early and accurate diagnosis of dementia and its management. Mild Cognitive Impairment is an organic condition which in significant proportion of cases, progresses to Dementia. In Bedfordshire and Luton, patients with MCI are followed up at nine months to yearly intervals and detailed neuropsychological assessments are carried out to monitor cognitive functions in order to detect dementia early and plan care at an early stage in line with the NICE guidance CG42. An interesting patient presented to the Memory Clinic. He suffered from bipolar disorder with age of onset after 50 years. He was successfully treated with a combination of antidepressants, antipsychotics and lithium carbonate. He started complaining of memory difficulties and the initial memory assessment concluded that he had MCI. He was followed up by the clinical psychologist at memory assessment services at yearly intervals. There were no active cognitive interventions done by the psychologist. In the meanwhile the patient developed Parkinson's disease and was treated successfully with levodopa. Following this, neuropsychological tests demonstrated a significant improvement in cognitive functions. The patient was assessed as having recovered from mild cognitive disorder. In this article the authors discuss the possible differential diagnosis and causative factors for the presentation of MCI in this patient. Furthermore the possible reasons for recovery are explored. This also raised interesting questions as to the pharmacological management of mild cognitive disorder secondary to neurological conditions and as to how the course of mild cognitive disorders could be modified by effective interventions.
authors.affiliation: Weller Wing Mental Health Unit, South Essex Partnership University NHS Foundation Trust, Bedford, UK, seshmadhavan@gmail.com.
authors.forename: Madhavan
authors.initials: M
authors.lastname: Seshadri
authors.forename: Nadeem
authors.initials: N
authors.lastname: Mazi-Kotwal
authors.forename: Mark
authors.initials: M
authors.lastname: Aguis
mesh_terms: D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome