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Picks Disease

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Pick's disease is a relatively rare, degenerative brain illness that causes dementia. The first description of the disease was published in 1892 by Arnold Pick. It usually begins after age 40 and is less common after age 60. It is a disease that invariably worsens. The average course is about 5 years, but it ranges from 2-15 years. It is rare, accounting for between 1% and 5% of dementia.

Until recently it was thought that Pick's disease could not be distinguished from Alzheimer's disease during life. Consequently, it has been studied little, and much less is known about it than about Alzheimer's disease.

Pick's disease differs from Alzheimer's disease in several ways. First, Picks is much rarer, occurring only 1/10th as often. The two diseases also produce different abnormalities in the cells of the brain. Pick's disease is marked by "Pick bodies", rounded, microscopic structures found within affected cells. Neurons swell, taking on a "ballooned" appearance. Neither of these changes appears in Alzheimer's disease, and the pathology of Alzheimer's disease (plaques and tangles) is not found in Pick's disease. Secondly, Pick's disease is usually sharply confined to the front parts of the brain, particularly the frontal and anterior temporal lobes. This contrasts with Alzheimer's disease, which is more widely distributed. The two diseases also produce different neurochemical changes in the brain.

These basic differences between Alzheimer's disease and Pick's disease mean that the two tend to produce somewhat different symptoms. In contrast to Alzheimer's disease, in which early memory loss predominates, the first symptoms of Pick's disease are often personality change and a decline in function at work and home.

"I noticed that I was starting to become less productive at work and was getting in trouble for it," Steve Kimball said. "I didn't realize it at first, but after being diagnosed with Picks and reading up on it, I look back at certain things I have done and patterns I have fallen into and I can see the symptoms for myself.

Personality change may take the form of apathy and indifference toward customary interests, or of disregard for social decorum and for the feelings of others. Poor social judgment, inappropriate sexual advances, or a coarse and jocular demeanor may be seen. Function declines because the patient simply does very little, or displays confusion and poor judgment. Often times the patient performs well when directed to do something, but cannot undertake the very same thing independently. Patients loose a sense of pride for their appearance and will often go long periods of time without bathing, grooming or dress appropriately. What is lost is the ability to initiate, organize, and follow through on even very simple plans and familiar activities.

"Our family will definitely need to provide more interaction and care for Steve as the disease develops," father Gus Kimball said." "Luckily Marty (brother) will be able to help out with the day-to-day housework since they live together."

Some become extremely apathetic and may sit for hours doing nothing at all unless prompted to do so by another person. Other victims become extraordinarily restless and may pace around their homes unceasingly. In some cases, the person may have abrupt and frequent emotional outbursts, some of which can be violent. Attention span is poor; patients seem to be distracted instantly by anything that they hear or see. Restlessness gives way to profound apathy and the patient may not respond at all to the surrounding world.

Some patients develop hyperoralistic behaviors which are compulsive in nature. They may display hypersexual behavior. This can possibly lead to inappropriate sexual advances, jokes and compulsive masturbation. Gluttonous eating occurs in some cases which proposes a major health concern, especially for those already overweight. Some show signs of dietary compulsions, in which the person



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