Dementia and Unusual Neurological Decline: When to Refer

Neurological Decline Is Not Always Irreversible

When a person develops rapidly progressive cognitive decline, personality change, or unusual neurological symptoms, the differential diagnosis is broad — and critically, many causes are entirely treatable if identified early. Functional medicine's systematic approach to investigating neurological decline often reveals reversible causes that standard workups miss.

Treatable Causes of Neurological Decline to Always Investigate

FXMed tip: If any of this sounds familiar, our Immune Support Programme may be exactly what you need. Book a free assessment to find out where your health stands today.

• Thyroid (see our hormones guide) dysfunction — severe hypothyroidism causes "myxoedema madness"; fully reversible with thyroid hormone replacement
• Vitamin B12 deficiency — causes dementia, psychiatric symptoms, and spinal cord degeneration; fully reversible in early stages with B12 replacement
• Thiamine (B1) deficiency — Wernicke's encephalopathy causes acute confusion, eye movement abnormalities, and ataxia; treatable with IV thiamine but emergency requiring immediate action
• HIV encephalopathy — treatable with effective ART
• Neurosyphilis — common in Nigeria; fully treatable with penicillin; missed without specific serology
• Normal pressure hydrocephalus — classic triad of cognitive decline, gait disturbance, and urinary incontinence; surgically treatable
• Autoimmune encephalitis — increasingly recognised cause of acute psychiatric and cognitive change; treatable with immunotherapy
• Metabolic causes — liver failure, kidney failure, sodium and calcium abnormalities all cause reversible encephalopathy

FXMed's Neurological Decline Assessment

When cognitive decline or unusual neurological symptoms are identified, FXMed runs: thyroid, B12, folate, thiamine, HIV and syphilis serology, metabolic panel, inflammatory markers, and facilitates brain imaging. This systematic screen identifies reversible causes promptly. Urgent referral to neurology is arranged when findings require specialist input.

Act Early on Neurological Change

Any significant change in cognition, behaviour, or neurological function warrants prompt investigation. Book a consultation with FXMed — we investigate comprehensively and act on findings urgently.

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• Your Hormones Are Trying to Tell You Something

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At FXMed, we go beyond symptom management. Our Home Visit Service and Virtual Consultation bring evidence-based functional medicine directly to you, anywhere in Lagos. Our Immune Support Programme is designed specifically to address the root causes discussed in this article.

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