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Case 20

A 58 year old with rapid onset dementia

Terry Featherstone

A 58 year old man presented with a short history of profound lethargy, diminished concentration, memory impairment and poor balance. On admission he was disorientated in relation to time, place and person.

On examination he had intention tremor, truncal ataxia and bilateral grasp reflex. Blood tests revealed no abnormality. A CT scan was normal.

Thereafter an MRI scan was performed; the T1 weighted scans were normal. Sample axial proton density and T2 weighted images are shown. What are the findings, and what are the possible causes?