Neuro says Alzheimer’s, but GP says otherwise...

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Sarahk60 Asked March 2019

Neuro says Alzheimer’s, but GP says otherwise...

So my mom went to a neurologist and was diagnosed with Alzheimer’s. The neuro was gentle, vague and didn’t go on and on about it, but was direct with my sister who was in the room after my mom had left.

My mom had a ct scan a few days later that was ordered by her general practitioner (before she even had her appt with neuro).

The general practionet emails today and said ct scan shows nothing “acutely abnormal”. What the heck? Is that code for “there is something abnormal, but don’t worry” or does she maybe not have Alzheimer’s?

So confused.

Alzheimer's & Dementia Diagnostic Criteria

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score 1 · Answer 1

My guess is that the CT was checked for bleeds, masses and occlusions; and the 'nothing acutely abnormal' meant they didn't find any. The operative word is 'acutely.'

But don't guess - and especially, don't let me guess for you! Call the GP and ask him/her to explain what the report on the CT scan means. I don't want to depress you beforehand but I believe it to be most unlikely that it rules out Alzheimer's Disease.

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score 0 · Answer 2

I would listen to the Neurologist they are specialist. They have spent numerous years in studying the brain and the central nervous system (CNS). A CT only shows damages to the brain. Alz/dementia is more complex than just a CT or even a MRI. Neuros know what questions to ask. They also know what signs to look for such as body movement, how the person looks when asked a question because it isn't only the answers to the questions, but what is not being said and how the person acts when answering the questions. There is more going on than what a pt sees. CTs may show that there is no damage to the brain or the cranium but that doesn't mean that the brain is not damage. There is no real one test for Alz/dementia. All Drs can do is put pieces together in hope to get a clear picture. Medicine is a science, not an art! For this disease and many others all Drs can do is gather up as much information as they can and start ruling out what it is not!

As someone stated GP are great for everyday things, however, they did not go to the extra few years to become a specialist in one area.

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score 1 · Answer 3

Thanks! The neruo did the MMSE for her. She scored a 16. We’re just trying to confirm and are a bit confused as to how it all works.

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score 0 · Answer 4

MMMMM.... I would go with the specialist!
see this article...
https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048075

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score 1 · Answer 5

I agree, the scan was just to rule out anything physical that could cause the problem. There is a test that Moms neurologist did give Mom, an EEG. This test records electrical patterns of the brain.

I have a epileptic grandson, a nephew with a neurological problem and my Mom with Dementia all going to the same neurologist and he has never given a physical. There was a form filled out asking family history and any medical things you are experiencing. When my Mom was tested it was a series of tests. The way she answers is how they determine ALZ from the other Dementias because it does effect the brain differently. There are some great videos explaining how ALZ effects the brain.

PCP are good for everyday illnesses. They are called General Practitioners because their knowledge is a little of this and a little of that. He may suspect a Dementia but a neurologist has the knowledge to know it definitely is and prescribe the meds needed.

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score 0 · Answer 6

Thanks everyone!

On looking at the neuro’s notes it says she gave my mom a physical exam and noted each one in her notes.however, my sister said neuro didn’t check any of that.

Does a neuro normally give a physical exam as well? One of my kids is epileptic and her neuro usually does one, but I wasn’t sure if they do for Alzheimer’s.

cwillie...thank you for the link. That was actually very helpful.

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Hi Sarah,

Sorry you are going through this, I know how you feel, it's scary as hell.

My mom just had a neuro appointment, and they did a test called MMSE. It takes about 10 minutes and has 30 questions. My mom scared a 20, which indicates "cognitive decline" aka dementia. I'm wondering if that is what your mom had? I understand it's a very common screening test.

If you want something more comprehensive you could ask for a neuro-psych eval which is about 4 and a half hours long. The doctor suggested and ordered one of those for my mom.

Keep talking to the neurologist. If she has early ALZ then there may be meds to help slow the process. IMO of all the specialties in medicine, a neuro is who you need on board for dementia.

Also my mom had a stroke in 2014 so she's had a few MRI's. They show much more than a CT scan, and my mom's vascular disease was evident. That's why at the appointment we just had the doctor used the word "vascular dementia". I'm not sure what an MRI would show with ALZ, but it may give you more answers. Ask the neurologist if an MRI would be a good idea?

Good luck. You have found a great place to get help and support. This place has been a life saver for me.

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score 2 · Answer 7

Never heard of a CT indicating Alzheimer’s. Sounds to me like the GP was saying nothing medically horrible was found that could be seen on a CT, such as a tumor. Look at the stages of Alzheimer’s and prepare yourself to be honest as you compare them to your mom’s changes and behaviors. I’m guessing you’ll get a better idea where she is in the Alzheimer’s journey. I’m sorry your family is dealing with this, I lost an aunt to it, never an easy road

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score 1 · Answer 8

As far as I know only a PET scan can show early Alzheimer's, and even that isn't definitive because many healthy people have been found to have the plaques and tangles associated with ALZ. There are many other conditions that could cause the symptoms of dementia though, so brain scans are useful in ruling out that there isn't something else going on. I found an article you might find helpful:

https://www.helpguide.org/harvard/recognizing-and-diagnosing-alzheimers.htm/

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score 5 · Answer 9

There's no test for alzheimer's. There's no test for dementia in general. Those are diagnosed by looking at behavior more than anything else. There are plenty of people with brain shrinkage and spotting that have no dementia behavior. They are perfectly fine. There are people with dementia behavior with no brain shrinkage or spotting.

Medicine is an art, not a science. While some science is used in medicine, the overall system is qualitative not quantitative. The neurologist's diagnosis is his opinion, not a proven fact. The GP's diagnosis is his opinion, not a proven fact. You don't get much surety in medicine. You get opinions.

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This was a perfect post. Maybe I say that because it aligns with what I believe.
Doctors have a license to practice. That’s what they do.

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Neuro says Alzheimer’s, but GP says otherwise...

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