Xu T, Mei X, Zhao Z, Liu YH, Zheng CY. Effectiveness of anti-psychiatric treatment on visual and haptic perceptual disorder for a patient with Alzheimer’s disease: A case report. World J Psychiatry 2024; 14(9): 1404-1410 [PMID: 39319233 DOI: 10.5498/wjp.v14.i9.1404]
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02734574
Submitted on:
September 20, 2024, 01:48
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Reader Comments:
1. The case in this article needs to be clarified whether thought reaches delusional and its duration. If there is delusion, the diagnosis also needs to differentiate with delusional disorder. Another name is Ekbom syndrome, in which comprises of visual hallucinations and delusional parasitosis. Delusional parasitosis, which is characterized by a fixed and persistent belief of having a pathogenic infection despite objective evidence to the contrary.
2. The authors described the diagnosis of early dementia. However, the article did not mention the clinical course and symptoms of typical dementia in this patient, such as the patient's memory complaints, cognitive function deterioration, instrumental and basic activities of daily livings, and executive functions. The results of cognitive function assessment should be provided.
3. The case history mentioned that the patient had gait problems. The reader may wonder what the patient's neurological examination, especially the evaluation of the limbs and gait. A type of dementia called Lewy body dementia (DLB), and its core symptoms contain parkinsonism. DLB is also considered to be likely to have vivid visual hallucinations.
4. Authors can discuss the pathophysiology of psychotic symptoms in dementia and late life and review associated reports on the use of antipsychotics in such clinical situation.
5. If the patient meets the diagnosis of early dementia, the use of AchEI can be considered and discussed. Compared with antipsychotics, the advantage of using AchEI to treat psychiatric symptoms in dementia patients is that it does not affect cognitive function and has fewer extrapyramidal side effects.
6. Thanks for the author's paper.
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