Case Presentation
A 40-year-old female patient visited an outpatient clinic complaining of sleep disturbance, intermittent headache, and gradual subjective cognitive decline.
Physical Examination
- BMI- 21
- Blood pressure- 70/120
- Physical examination revealed no abnormalities.
Medical History
- No past medical history reported.
Family History
- Her mother was diagnosed with Alzheimer’s disease (AD) when she was in her 30s.
- There was no other past medical history.
Clinical Examination
- Her laboratory results, including a complete blood count, electrolytes, glucose, lipid profiles, and a thyroid function test, did not reveal any abnormalities.
- Her Apolipoprotein E genotyping was reported as E3/E3.
- Physical examination also revealed no abnormalities.
- A neuropsychological test battery was implemented to evaluate the patient’s cognitive status.
- She scored 21 on the mini-mental status examination (MMSE) and 0.5 on the clinical dementia rating scale (CDR) on the first time.
- F-fluorodeoxyglucose (FDG) positron emission tomography (PET) showed mild FDG hypometabolism in bilateral parietal and temporal lobes.
- However, 18F-florbetaben (FBB) amyloid PET revealed diffuse amyloid retention in the lateral temporal cortex, frontal cortex, posterior cingulate cortex/precuneus, parietal cortex, and cerebellum.
- Amnestic mild cognitive dementia was suspected.
Treatment
The attending neurologist prescribed galantamine 8 mg and decided to follow up after one year.
Clinical Outcome
At the next visit, she expressed the progression of memory decline and noted that recent memory loss has become more prominent