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Binswanger's Disease

Binswanger's Disease Definition

Binswanger's Disease, also known as subcortical dementia, is a rare form of dementia characterized by cerebrovascular lesions in the deep white-matter of the brain, mood changes, and loss of memory and cognition. Patients often show signs of abnormal blood pressure, blood abnormalities, stroke, disease of the large blood vessels in the neck, and disease of the heart valves. Other prominent features of the disease include urinary incontinence, clumsiness, difficulty walking, speech difficulty, slowness of conduct, and lack of facial expression. These symptoms, which tend to start after the age of 60, are not present in all patients and may sometimes appear only as a passing phase.

Binswanger's Disease Prognosis

BD is a progressive disease and has no cure. Changes may start suddenly or gradually and then progress in a stepwise manner. BD can often occur with Alzheimer's disease. Behaviors that slow down the progression of diabetes, high blood pressure, and atherosclerosis (such as eating a healthy diet and keeping healthy wake/sleep schedules, exercising, and not smoking or drinking too much alcohol) can also slow down the progression of BD. Binswanger's disease has no known treatment, let alone a cure, although drugs that are used to treat high blood pressure, depression, arrhythmia and low blood pressure can be used to treat the condition's symptoms.

Binswanger's Disease Symptoms and Signs

A person affected with Binswanger's disease may show signs of dementia, loss of memory, loss of cognition, mood changes, self-centeredness, and childish behavior. They may also suffer from depression and may have a particular dislike for unusual events. Some obvious symptoms are difficulty walking, clumsiness, slowness of conduct, lack of facial expression, speech difficulties, and Parkinson-type tremors. Patients may also suffer from an abnormal blood pressure (either too high or too low), stroke, blood abnormalities, seizures, and urinary incontinence. Other symptoms include progressive dementia, arteriosclerosis, and subcortical demyelination.

Binswanger's Disease Treatment

There is no specific course of treatment for Binswanger's disease. People with depression or anxiety may need antidepressant medications such as the serotonin-specific reuptake inhibitors (SSRI) sertraline or citalopram. Atypical antipsychotic drugs, such as risperidone and olanzapine, can be utilized in individuals with agitation and disruptive behavior. Recent drug trials with the drug memantine have displayed improved cognition and stabilization of global functioning and behavior. The successful management of hypertension and diabetes can also slow down the progression of atherosclerosis, and subsequently slow the progress of BD. Since there is no cure, the best treatment is preventive, early in one's adult years, by controlling risk factors such as hypertension, diabetes, and smoking.

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