Pick Disease Differential Diagnoses

Updated: Nov 18, 2019
  • Author: Monica Saini, MBBS, MD; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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DDx

Diagnostic Considerations

Diagnostic guidelines for svPPA specify the following criteria: [39]

  • [A] Core features: anomia and single-word comprehension deficits (both essential for diagnosis), plus
  • [B] at least 3 of the following other diagnostic features:
    1. impaired object knowledge, particularly for low- frequency or low-familiarity items
    2. surface dyslexia or dysgraphia
    3. spared repetition; and
    4. spared speech production (grammar and motor speech).

The diagnosis of FTD requires a clinical and neuropsychologic approach, supported by neuroimaging and/or genetic studies. Diagnostic criteria for bvFTD were revised and published in 2011. [40]

For a correct clinical diagnosis of FTD, it is useful to see patient and caregiver first together, and then separately, to apply consensus criteria clinically, and to utilize scales that elicit symptoms that are indicative of FTD rather than AD.

Conditions to consider in the differential diagnosis of Pick disease include the following:

  • Rarely, subcortical stroke, for example affecting the striatum

  • Primary brain tumors of the frontal lobe, pituitary, or related regions

  • Adult polyglucosan body disease

  • Chronic meningitis

  • Hashimoto encephalopathy

  • Hemochromatosis (controversial)

  • Creutzfeldt-Jakob disease

  • Olfactory groove meningioma

  • Sequential bilateral thalamic strokes

  • Herpes simplex encephalitis

Differential Diagnoses