Pick's Disease

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Pick's Disease Diagnosis & Tests

The health care provider bases on initial diagnosis on history and symptoms, signs, and tests, and by ruling out other causes of dementia including dementia due to metabolic causes. Neurologic examination may reveal signs that vary according to the which part of the brain is afffected. Temporal and frontal lobe signs are most common, with resulting behavioral and language changes. There may be other abnormalities, including frontal release signs (presence of abnormal reflexes) and exacerbation of muscle stretch reflexes. Psychologic studies and tests of sensation, cognitive function, and motor function may be abnormal.

• Neuropsychologic assessment shows a pattern of mental decline that suggests selective loss of cognitive function that can be localized to the frontal and/or temporal lobes of the brain.
• An EEG (electroencephalogram) shows nonspecific changes in electrical activity of the brain.
• A head CT scan shows atrophy (loss of tissue mass) of affected lobes of the brain.
• A brain MRI can detect mild degrees of frontal and temporal atrophy missed by the head CT scan
• Cerebrospinal fluid examination after a lumbar puncture is usually normal.

It is important to note that the definitive diagnosis can only be made by brain biopsy since the demonstration of Pick bodies must be done with a microscope by an experienced neuropathologist. However, ongoing efforts are directed at developing a biological marker that would allow a firm diagnosis without the need for such an invasive procedure.