Pick’s Disease

Clinical Features

Pick’s disease Opens in new window is a rare form of progressive dementia clinically indistinguishable from Alzheimer’s disease Opens in new window. It is about one-fifth as common as Alzheimer’s disease. Pick’s disease occurs in middle adult life and has a duration that varies from two to 15 years. It has a strong familial tendency, but a definite genetic pattern has not been established. ACh levels are reduced.

The clinical features of Pick’s disease are quite similar to those of Alzheimer’s disease, and since neither condition is curable an elaborate differential diagnosis is unnecessary.

Because of parietal sparing, such features as apraxia and agnosia are less common in Pick’s disease, and visual spatial ability, often impaired in Alzheimer’s disease, is preserved.

Given the prominent changes in the frontal lobe, disinhibited behavior, loss of social constraints, and lack of concern about appearance and matters of personal hygiene occur relatively early in Pick’s disease.

Such speech disorders as echolalia and logorrhea are common, and patients with Pick’s disease are more likely to develop Klüver-Bucy syndrome (orality, hyperphagia, hypersexuality, placidity) indicative of damage to the temporal lobes. Significant memory impairment may occur relatively late in the course, and eventually the patient becomes listless, mute, and ultimately decerebrate and comatose. The treatment of Pick’s disease is symptomatic.