Man with Memory Loss, Odd Behavior and Dementia: Questioning Medicine’s Ivory Tower

by | Jan 19, 2021 | Brain/Cognitive, Chronic Disease

New England Journal of Medicine (NEJM) recently published a case study on a 62-year-old man with memory loss, personality changes and odd behavior in the December 31, 2020 issue. I found the case study interesting and it revealed the current state of standard medical care by one of the best medical institutions in the country. For better or worse, you can be a judge on this case.

In a brief summary, five years before evaluation in a leading Boston hospital, the patient’s wife noticed that the patient was becoming more forgetful and napped frequently during the day, and showed a lack of initiative in his professional work. He became distant with family, less talkative, lacked interest in activities that he had previously enjoyed and made frequent costly errors at work.

Previously he was evaluated by neurology/psychiatric clinics and extensive lab tests, including a Lyme test, were all negative. He was diagnosed with attention deficit-hyperactivity disorder, adjustment disorder, and avoidant personality traits. Psychotherapy was started and amphetamine was prescribed.

Despite the medications he had progressive personality changes, memory loss and difficulty with daily function and he was unaware of his inappropriate and unusual behaviors. He did not report having anxiety or depression. There was no history of head trauma or seizure but he had a history of Waldenstrom macroglobulinemia, kidney stones, mitral valve prolapse, spinal stenosis, benign prostate hypertrophy, and arthritis.

His physical exam was normal; Mini-Mental State Examination score was 23 on a scale ranging from 0 to 30 (with higher score indicating better cognitive function), and his Montreal Cognitive Assessment (MoCA) score was 15 on a scale from 0 to 30 (with higher score indicate better cognitive function).

After extensive neuropsychological assessment and MRI showing atrophy of frontotemporal lobe, the working diagnosis was, “Behavioral variant of frontal dementia, not Alzheimer’s disease.” He was treated with pharmacologic management with Zoloft and Trazodone. His neurocognitive function continued to decline and he eventually died at 69 years old.

Autopsy was performed; his brain weighed 910 grams (normal range is 1250 to 1400), with severe atrophy of the frontal lobes and the anterior portion of temporal lobe. Brain specimens showed numerous eosinophilic cytoplasmic inclusions, known as Pick bodies with positive tau protein. The final diagnosis was Frontotemporal lobar degeneration with tau-positive inclusion consistent with Pick’s disease. Pick’s disease is called Frontotemporal dementia (FTD), a rare form of dementia that is similar to Alzheimer disease, except that it tends to affect only certain areas of the brain. It is a rare type of age-related dementia that affects the frontal lobes of the brain and causes speech problems like aphasia, behavior difficulties and eventually death. It was first described by Czech neurologist and psychiatrist Dr. Arnold Pick in 1892 before Dr. Alois Alzheimer described Alzheimer’s disease in 1906.

To be fair for the case, this patient had too far advanced disease and irreversible neurodegenerative dementia by looking at the MRI and autopsy of the brain. By the time a patient is diagnosed with Pick’s Frontotemporal Dementia or Alzheimer’s disease, the damage to the brain is often irreversible.

We should focus instead on prevention and reversing the early stages of dementia, 10-20 years earlier, by screening for and treating underlying problems. Parasites, fungal, dental and environmental toxins (Medical and Dental – MAD complex) are not a part of the current medical knowledge data base for constructing case studies, evaluation and treatment plans. Is it possible to prevent and reverse the course? Please read my previous article, Cognitive Decline to Dementia & Alzheimer’s Disease: Unsuspected Parasite-Dental-Oral Infections, on my website.

Table: Risk factors for Alzheimer’s and Other Neurodegenerative Disease

Demographic & SocialGenetic VariantsDiet/Nutrition & LifestylePreexisting ConditionsEnvironment/ ToxinsPathogens
AgeAPOE4NutritionCancerAir pollutionBacteria
GenderABCA7AlcoholCVD/CHFWater damageMycobacteria
Race/EthnicityCLUDrugsDiabetesWorkplaceMycoplasma
IncomeCR1SmokingLipid disorderMilitaryFungi/Mold
EducationPICALMExerciseObesitySolventsLyme
GeographyPLD3ActivitiesStroke/TBIMercuryParasites
EmploymentTREM2LearningAnxiety/DepLead, CopperViruses
Marital StatusSORLI1PrescriptionsStress/TraumaAluminumDental/Oral

The brain specimens showing numerous eosinophilic inclusions, known as Pick’s bodies, make me suspect unsuspected oral-dental-parasites influencing the brain. There was no mention of dental history because we as physicians do not have training in medical and dental (MAD) related evaluation and overlook the crucial neglected medical/dental history. The more you have dental work done on infected teeth, i.e. root canals rather than extractions, the greater the risk of developing neurologic disorders, per neurologist Patrick Stortebecker, MD, PhD of Sweden.

It is time to question the wisdom of Ivory Tower’s Medical establishment. About-Face, and take a close look at Dental and Medical Mysteries (DAMM). You may feel MAD about our current medical practice. We need to bridge the medical/dental professions and become medical and dental (MAD) physicians. Acupuncture Meridian Assessment (AMA), based on 5,000-year-old technology, can connect the dots and missing links through meridians for DAMM MAD physicians. Check out my JEDI Project and AMA Training in St. Louis.

For Patients

About Dr. Yu

Dr. Simon Yu, MD is a Board Certified Internist. He practices Internal Medicine with an emphasis on Integrative Medicine to use the best each has to offer. For more articles and information about integrative medicine, patient success stories, and Dr. Yu’s new book, AcciDental Blow Up in Medicine: Battle Plan for Your Life, visit his website at www.preventionandhealing.com or call Prevention and Healing, Inc., 314-432-7802. You can also attend a free monthly presentation and discussion on Integrative Medicine at his office on the second Tuesday each month at 6:30 pm. Call to verify the date. Seating is limited, arrive early.

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