Dr. Aida Abaz Quka
Neurology
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Patient's Query
Hello doctor,
My grandfather is 89 years old. He got operated for femur neck fracture on 14 February 2020. After that, he experienced visual hallucinations. Before operation, he suffered from auditory hallucinations and words did not come to his mouth. He was facing difficulty in recalling names and words. A CT was done which revealed multiple small hypodense lacunar infarcts in bilateral ganglion capsular region, bilateral thalamic capsular region, bilateral frontoparietal white matter, and brain stem. He is currently on Ecospirin 75 mg, Alzil m and Folvic medicine for schizophrenia, but no relief.
Hello,
Welcome to icliniq.com.
Based on your description and on these CT (computed tomography) scan findings (attachment removed to protect patient identity), I would conclude about vascular dementia which is a degenerative disease of the brain.
I agree with the medication and would recommend increasing the dose of Alzil (Donepezil) to 10 mg daily and add Memantine 10 mg each day to his therapy.
Unfortunately, this is a progressive disease and these drugs will not do miracles. His situation may slightly improve after increasing the dose of the drugs, but he will worsen again as time passes.
I hope this helps.
Patient's Query
Thank you doctor,
Can you just tell me that he is in which stage of vascular dementia? He can eat on his own but he forgets daily how to flush the toilet probably due to the new seat. He wears his clothes on his own but he is very inactive and not talking much. Although he can do addition and multiplication. Through the medicines how long can this disease be delayed from reaching its final stage?
Hello,
Welcome back to icliniq.com.
Based on your description, it seems to be a moderate stage of dementia. Anyway, consulting with a neurologist and performing cognitive tests would help classify exactly the stage of dementia. I recommend making the above-mentioned changes to his medication, in order to help improve his situation.
I hope this helps.
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Neurology
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