Author(s):
Rapidly Progressive Dementias are characterized by a subacute or acute decline in neurologic function and causes run the gamut from easily reversible to universally fatal. The sudden onset and abrupt decline are distressing for patients and caregivers and present a unique challenge for clinicians. In the absence of readily apparent cause, many will move to a presumptive diagnosis of prion diseases is a diagnosis which can only be confirmed after death. In patients taking neurotoxic medications, to include such routine medications as lithium, tricyclic antidepressants, or even bismuth-based antacids, a ‘medication vacation’ should be considered to rule out an iatrogenic cause. Based on numerous case reports, a ‘vacation’ is still recommended in the setting of therapeutic serum medication levels.
