Next time the patient is seen, get him or her to draw you a picture of a man or a clock. If there are indications of impairment in spatial function or signs of distortion of the body schema/representation in the brain, then neurological possibilities could be explored if the problem persists ? parietal in nature.
Regarding the above comment, the email address is firstname.lastname@example.org - Arthur Kaufman
Sleep problems also apply to children and can prove very exhausting to parents. In June 1985, then called General Practitioner I had published an article entitled 'When a child won't sleep there may be a simple answer;' It was based on the assumption that by way of a behavioural programme of partial rousing when the child was asleep, he or she could be trained or learn to sleep for increasingly longer intervals and thus acquire a better sleep pattern. Can email or send a copy of the article by post or can discuss it by phone (07789 133651) with interested GPs. Arthur Kaufman.
Some years ago an article of mine appear in Pulse on a training programme to try and establish a 'natural' sleep pattern. If anyone would like to contact me about this article, - email@example.com - 07789 133651, I would be pleased to hear from them.
Arthur Kaufman BA Msc AFBPS
Patients with such as faulty concentration and depressed mood and feeling anxious during examination may be diagnosed as demented when with appropriate treatment the prognosis is otherwise good, although after the wrong diagnosis is made, they or their relatives may have made unnecessary and important if not irreversible decisions about their future. The differential diagnosis issue is obviously of crucial importance.
The diagnosis of dementia, particularly in its early stages is one of the most differential diagnoses to make. Also, examination by 'tick box' may cause a patient considerable distress, especially those already stressed by worries over memory or other cognitive difficulties which might be due to depressed mood or other causes of a non progressive nature.