A Massachusetts woman baffled doctors when her dementia caused her to deteriorate frighteningly quickly.
In just five months, the 78-year-old went from living independently to having difficulty forming sentences and needing help with basic tasks like bathing and eating.
A relative had died weeks before the woman’s deterioration, so the woman’s daughter attributed the symptoms to pain, until it became clear that something was seriously wrong.
Doctors struggled to reach a diagnosis, meaning the woman was repeatedly sent for tests at some of the top hospitals, including Massachusetts General Hospital, Harvard Medical School, the University of Pittsburgh and the University of Calgary.
The 78-year-old woman began to experience unexplained rapid and severe cognitive decline (file photo)
It was eventually discovered that he had undiagnosed lung cancer that had spread to his lymph nodes, as well as a toxic buildup of amyloid proteins in his arteries.
The woman was diagnosed with paraneoplastic encephalomyelitis (PEM), an inflammation of the brain and spinal cord that causes confusion, brain bleeding, cognitive impairment and difficulty thinking and speaking, similar to Alzheimer’s.
PEM is a rare neurological disorder that affects less than one in 100,000 people each year.
It develops due to the presence of cancer in some part of the body.
The patients case It was detailed in The New England Journal of Medicine.
Doctors said her symptoms began with a “flat affect,” which the patient’s daughter had attributed to grief following the death of the woman’s sister.
She then developed ‘more severe memory problems’ and was admitted to hospital following a terrifying episode in which she struggled to speak.
An MRI scan revealed that areas of his brain tissue were damaged by repeated lack of blood supply, indicating he may have suffered a stroke.
But with no conclusive answers, doctors sent her home. Just 10 days later, the patient was becoming more impulsive, confused and forgetful.
Her primary care physician prescribed her medication to treat “possible depression.”
Over the next few weeks, the woman’s condition continued to deteriorate rapidly and she began to require more help with daily living and bathing, as well as being reminded to eat.
Previous brain scans suggest a stroke, damage to brain tissue and narrowing of the brain’s vessels.
Her daughter once again took her to the hospital about four months later, where she underwent more extensive tests, including blood tests, a spinal tap, X-rays and another MRI.
Tests revealed the woman had brain abnormalities, with damage to brain tissue and brain vessels, affecting the way blood and oxygen reached the organ.
Following her formal diagnosis, the patient underwent steroid treatment but did not receive chemotherapy due to her family’s concerns about her poor memory and confusion.
However, he underwent immunotherapy for six months.
The patient was also given medication to treat seizures, and the authors of the case report wrote that his confusion decreased slightly and his consciousness improved.
She was discharged from the hospital and moved to a nursing facility with steroid treatment. However, she became paranoid and confused and her memory worsened.
After finishing the steroid treatment, she developed respiratory distress and pneumonia and was admitted to the intensive care unit. When her condition began to deteriorate, the family decided to forego the intervention and offer her palliative care at the end of her life.
The woman died in a hospice.
