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Steroid dementia: an overlooked diagnosis?
Oliver Sacks1, Melanie Shulman
1Albert Einstein College of Medicine, Bronx, NY, USA.
Neurology
|February 25, 2005
Summary
High-dose prednisone can cause reversible dementia in patients with polymyalgia rheumatica. Steroid discontinuation led to rapid cognitive recovery, highlighting a crucial, often overlooked, side effect for physicians.
Area of Science:
- Neurology
- Rheumatology
- Psychiatry
Background:
- Polymyalgia rheumatica is an inflammatory condition often treated with corticosteroids.
- Corticosteroids, like prednisone, are widely used for their anti-inflammatory properties.
Observation:
- A 72-year-old male patient with polymyalgia rheumatica developed psychosis and dementia after three months of 100 mg prednisone daily.
- Initial assessment suggested a neurodegenerative process, possibly Alzheimer's disease.
Findings:
- Cognitive function and psychosis resolved rapidly upon discontinuation of prednisone.
- Literature review confirmed that steroid-induced reversible dementia is an under-recognized complication.
Implications:
- Physicians should consider corticosteroid-induced neurotoxicity in patients presenting with new-onset dementia, especially during high-dose or prolonged therapy.
- Increased awareness of this reversible cause of dementia is critical given the widespread use of steroids in medicine.
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