Symptoms:

The disease gets worse slowly. Tissues in the temporal and frontal lobes of the brain start to shrink over time. Symptoms such as behavior changes, speech difficulty, and impaired thinking occur slowly, but continue to get worse.

The early personality changes can help doctors tell Pick's disease apart from Alzheimer' s. (Memory loss is often the main, and earliest, symptom of Alzheimer's.)

People with Pick's disease tend to behave the wrong way in different social settings. The changes in behavior continue to get worse and are often one of the most disturbing symptoms of the disease. Some patients will have more prominent difficulty with decision making, complex tasks, or language (trouble finding or understanding words or writing).

General symptoms are listed below.

Behavioral changes:

• Can't keep a job
• Compulsive behaviors
• Inappropriate behavior
• Inability to function or interact in social or personal situations
• Problems with personal hygiene
• Repetitive behavior
• Withdrawal from social interaction

Emotional changes:

• Abrupt mood changes
• Decreased interest in daily living activities
• Failure to recognize changes in behavior
• Failure to show emotional warmth, concern, empathy, sympathy
• Inappropriate mood
• Not caring about events or environment

Language changes:

• Can't speak (mutism)
• Decreased ability to read or write
• Difficulty finding a word
• Difficulty speaking or understanding speech (aphasia)
• Repeat anything spoken to them (echolalia)
• Shrinking vocabulary
• Weak, uncoordinated speech sounds

Neurological problems:

• Increased muscle tone (rigidity)
• Memory loss that gets worse
• Movement/coordination difficulties (apraxia)
• Weakness

Other problems:

• Urinary incontinence

Signs and tests:

The doctor will ask you about your medical history and symptoms.

Your health care provider might order tests to help rule out other causes of dementia, including dementia due to metabolic causes. Pick's disease is tentatively diagnosed based on symptoms and results of tests, including:

• Assessment of the mind and behavior (neuropsychological assessment)
• Brain MRI
• Electroencephalogram (EEG)
• Examination of the brain and nervous system (neurological exam)
• Examination of the fluid around the central nervous system (cerebrospinal fluid) after a lumbar puncture
• Head CT scan
• Tests of sensation, thinking and reasoning (cognitive function), and motor function

A brain biopsy is the only test that can confirm the diagnosis.