Case 2:
A 75-year-old woman, who is a homemaker and has completed 12 years of
schooling, was referred to the neuropsychiatric clinic because she has
been experiencing memory loss for events and often asked the same
questions since 1.5 years ago. She had profound sadness and frequently
cried over the previous year after the passing of her spouse. The
presence of RBD was detected. In the past one year ago, she has been
experiencing intense visual hallucinations. For example, she sometimes
perceives the presence of two children in her home and engages in
conversations with them. Once, she had an unusual visual hallucination
known as an after-image, referred explicitly to as Palinopsia. She saw a
canine on the road, and after three hours, she reencountered it while
traversing a different street, ten kilometers further. Previous medical
history encompasses ischemic heart disease, hypertension, and a record
of thyroid surgery. Currently, a psychiatrist has recommended a daily
dosage of 200mg of Pregabalin, 25mg of Nortriptyline, and Ginkgo biloba.
The neurological examination indicated the presence of stiffness on the
left side, slowness of movement in the upper limbs, and slight resting
tremor. The overall MoCA score was 15, with an additional point for 12
years of schooling. The sub-scores were as follows:
visuospatial/executive function 1 out of 5, Naming 2 out of 3, Attention
3 out of 6, Language 1 out of 3, Abstraction 1 out of 2, Recall 0 out of
5 (MIS= 6 out of 15), and Orientation 6 out of 6.