Monday, July 25, 2011

Dementia


Dementia
The latest medical report of Suresh Kalmadi is not conclusive about dementia. According to Tihar Jail authorities, an MRI conducted on him at LNJP Hospital shows, in medical jargon, 'diffused cerebral atrophy with old ischemic changes in brain parenchyma with calcified granuloma in caudothalamic groove on left side (of his brain)'.

This condition, say neurologists, can be induced by diabetes. The 66-year-old politician has been referred to All IndiaInstitute of Medical Sciences (AIIMS) for further clinical examination. "The MRI report is not specific about dementia. It shows there are micro-angiopathic changes in the brain which can be induced by other factors like diabetes and high blood pressure," said an eminent neurologist who did not wish to be quoted. He said the condition described in the report occurs when there is lack of supply of blood to small areas of the brain.

"The damage and complications in this case, including memory loss, can be age-related factors combined with the effect of heart disease and diabetes. To check if the person has dementia or not, clinical examination - including memory function impairment test, language function, personality and behaviour test - need to be conducted," he added. Kalmadi, who has been lodged in the jail since April 25 for alleged irregularities in CWG, is being treated for heart surgery and diabetes at the jail hospital and was referred for expert advice to Deen Dayal Upadhyay Hospital. "On July 19, an MRI scan was conducted on him at LNJP Hospital, and based on that report, he has now been referred to AIIMS for further examination," said a jail official. He claimed that in the MRI report, some cerebral problems were noted that had little to do with dementia per se. "Dementia is a clinical diagnosis which will be known only after proper diagnosis. He has been referred to the neurology department at AIIMS for the same and a diagnosis will take place there. None of the symptoms reported in the MRI is exclusive to dementia," explained a senior Tihar official under the condition of anonymity.

Experts said Kalmadi will have to undergo a set of tests at AIIMS where he can be given some things to remember and execute certain commands. "In a clinical examination for dementia, the patient is given some things to remember to check whether he has registered them or not. To check his language function - whether he can comprehend verbal commands or not - he can be asked to touch his left eye or touch the nose with the right-hand thumb," said an expert. He said that memory loss, if any, has to be progressive in order to term it as dementia. Also, there has to be progressive impairment of at least one other cognitive ability for example recognition.

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