Differential Diagnosis for Forgetfulness, Abnormal Movements, and Excessive Sleepiness
Single Most Likely Diagnosis
- Huntington's Disease: A progressive brain disorder that causes problems with movement, emotion, and thinking. The combination of forgetfulness, abnormal movements (chorea), and excessive sleepiness, although not exhaustive, points towards this diagnosis given the relatively short duration of symptoms.
Other Likely Diagnoses
- Parkinson's Disease: Although more commonly associated with rigidity and bradykinesia, some forms of Parkinson's can present with abnormal movements and cognitive issues. Excessive sleepiness is also a common non-motor symptom.
- Dementia with Lewy Bodies: Characterized by cognitive decline, hallucinations, and fluctuations in alertness, which could explain the sleepiness and forgetfulness. Abnormal movements can also occur.
- Frontotemporal Dementia: A group of disorders caused by cell degeneration in the brain's frontal and temporal lobes, leading to changes in personality, behavior, and language, but can also include motor symptoms and sleep disturbances.
Do Not Miss Diagnoses
- Prion Diseases (e.g., Creutzfeldt-Jakob Disease): Rare, fatal brain disorders that can cause dementia, abnormal movements, and myoclonus, with a rapid progression of symptoms.
- Wilson's Disease: A genetic disorder that leads to copper accumulation in the brain and liver, causing neurological symptoms like tremors, difficulty walking, and involuntary movements, as well as psychiatric and cognitive issues.
- Neurosyphilis: A complication of untreated syphilis infection that can cause a wide range of neurological problems, including dementia, personality changes, and difficulty with movement.
Rare Diagnoses
- Whipple's Disease: A rare, systemic bacterial infection that can cause malabsorption, weight loss, and a variety of neurological symptoms, including dementia, memory loss, and abnormal movements.
- Fatal Insomnia (Fatal Familial Insomnia): An extremely rare genetic degenerative brain disorder that leads to severe insomnia and other neurological symptoms, eventually resulting in complete inability to sleep, followed by rapid deterioration and death.
- Progressive Supranuclear Palsy (PSP): A rare brain disorder that causes serious problems with walking, balance, and eye movements, and can lead to cognitive and personality changes.