[Differential diagnosis of presenile dementia from the neurological viewpoint]

The author shows that dementia does not exist as a disease as such. Therefore, efforts in terms of differential diagnostics are required to investigate this psychopathological syndrome which may conceal a number of clinical pictures which are easy to treat or manifest themselves as dementia. If a patient suffers from dementia, the physician must not give in to diagnostic and therapeutical nihilism. Diagnosing the existence of dementia is just as inadequate as diagnosing the existence of a shoulder-hand syndrome. The reasons must be found and a number of advanced invasive and non-invasive methods are available today such as ultrasonography, computer tomography, measurements of the regional blood supply of the brain, angiography, electroencephalograms, laboratory tests, etc. Although all these advanced methods exist, a careful anamnesis and the clinical findings continue to be of significance for the aetiology of the disease. The author does not mention very rare diseases such as the group of leucodystrophies and subacute sclerosing panencephalitis, nor does he refer to diseases such as Whipple's disease, Creutzfeldt-Jakob disease, vitamin deficiencies and hormonal conditions, which may also accompany dementia.