Can my 26 year old daughter have dementia?

Hi my previously healthy 26 year old daughter other then severe episodic migraine with aura genetic  from her father, has been declining slowly for 2 years. A previous ivy league graduate and very outgoing girl has become homebound. It first began with her complaining she couldn't intiate  movement  in 2009 she then complained of her eyes feeling so weak she felt like she couldnt keep them open even after ample rest. She complained of her Her arms and legs feeling sore and weak with numbness and feeling very heavy in first stages of symptoms. She was putting Bengay all over her joints. At this point her cognition was sharp and personality changes weren't evident. She then developed a severe stiff neck a year ago in which now she can barely move due to pain amd stiffness. Then in the past 6 months she has become to progress into a mild dementia. She was getting lost in familiar places and keeps complaining she can't recognize herself and others. Her personality is flattened and she is very quiet with trouble writing and spelling. Her gait seems fine but she complains of severe off balance and dizziness. Her vision she says is mildy doubled and she has photophobia severely. Motion makes her Ill and she cannot run her business anymore. She has seen a nuerologist, ent, and infectious disease. They have done all bloodwork, mris head, neck, and EEG, and clinical exam in 6/11 which was normal and neuropsych test. But her condition has worsened cognitively since then. There are times she blanks out more but chronically she seems her mental abilities are declining slowly. They have ruled out lymes, lupus, Wilson's disease, and ms due to testing. I'm not sure if she should have a spinal tap ? Could it be a cns infection invading the brain? We are trying to put the pieces of this puzzle together and any expert perspective would great help.
She is seeing a dr in Columbia soon, Could this be dementia? Or something they missed of a cns infection? Any help appreciated.

[Shiv Kumar, MD]

Dear Bodylove222,

I understand your concern.

I appreciate your initiative to seek more insight into your daughter's condition. I can understand how difficult it could be to deal with such a frustrating problem.

Cognitive impairment, memory problems, gait disturbances, stiffness along with weakness suggest multiple neuraxis involvement. Normal MRIs usually rules out treatable causes of such involvement. CSF infection can be ruled out only after spinal tap evaluation.  I personally feel she is probably suffering from some kind of neurodegenerative illness. Dementia (loss of memory) could be a part of such a degenerative process. One specific probability could be a very rare condition called prion disease. You could discuss this with your neurologist.

However, one has to rule out certain treatable causes before concluding it as a degenerative disease. So, I personally feel you need to see a Neurologist for a good clinical examination and undergo detailed evaluation for of rapidly progressing neurological condition. She needs evaluation to rule out seizures as the cause of black outs in her.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Shiva Kumar R.

[Bodylove222]

Thankyou Dr. I appreciate your help and advice.  I am going to address a spinal tap to her neurologists. So to understand what you are advising as possible diagnoses? Wouldnt a degenerative disease show with an MRI? what test would show degenerative diseases? Thanks in advance Dr.

[Shiv Kumar, MD]

Dear Bodylove222,

Thanks for writing back.

In case of degenerative diseases, most of the signs on an MRI are seen only in the advanced stages. During the initial stages, most of the degenerative and metabolic problems of the brain are not visible on MRI. MRI is usually normal or sometimes shows only atrophy of the brain. Further tests in such cases can be ordered based on the suspected syndrome. ‘Syndromic diagnosis’ can be reached only with a good neurological examination. Without an examination, I am unable to label the disease as any particular syndrome.

Hope that this information helps and hope that you will get better soon.

Best Regards,
Dr. Shiva Kumar R.