Binswanger's Disease

Binswanger's disease is a rare form of dementia. It is characterized by damage to the deep layers of white matter in the brain. People who have Binswanger's disease have problems with memory, making decisions, mood changes, and appropriate behavior.

CAUSES

Binswanger's disease is caused by the hardening of the arteries (atherosclerosis) in the brain. As the arteries become narrow and eventually blocked, the brain does not get enough oxygen, and the brain tissue dies. There are certain things that make atherosclerosis worse. These things include:

  • Smoking.

  • High blood pressure.

  • High cholesterol.

  • Diabetes.

SYMPTOMS

  • Short-term memory loss.

  • Mood and personality changes.

  • Decreased attention span.

  • Decreased ability to make decisions.

  • Behavior problems.

  • Slower movements.

  • Changes in speech.

  • Unsteady movement (gait) and frequent falls.

  • Loss of urinary control.

DIAGNOSIS

Your caregiver will gather information based on your symptoms and exam. Other evaluations may include:

  • Memory testing.

  • Lab tests.

  • Brain imaging scans (CT scan, MRI).

TREATMENT

There is no specific course of treatment for this disease. Treatment depends on what symptoms you have. It often involves medicines to control:

  • High blood pressure.

  • Depression.

  • Irregular heartbeats or rhythms (arrhythmias).

  • Behavior and memory problems.

Binswanger's disease is a slowly progressive condition. Changes may be sudden or gradual and then get progressively worse. The best way to slow the progression of Binswanger's disease is to take care of the things that make it worse, such as high blood pressure, smoking, high cholesterol, and diabetes. There is no cure for it. The disorder is often marked by strokes and partial recovery.

HOME CARE INSTRUCTIONS

  • Take your medicine as prescribed by your caregiver.

  • Eat a healthy diet.

  • Stay active for as long as you can.

  • Keep healthy sleep and wake cycles.

  • Stop smoking.

  • Limit alcohol. Women should have no more than 1 drink per day. Men should have no more than 2 drinks per day.

The care of individuals with dementia is varied and dependent upon the progression of the dementia. The following suggestions are intended for the person living with, or caring for, the person with dementia.

  • Create a safe environment.

  • Remove the locks on bathroom doors to prevent the person from accidentally locking himself or herself in.

  • Use childproof latches on kitchen cabinets and any place where cleaning supplies, chemicals, or alcohol are kept.

  • Put childproof covers in unused electrical outlets.

  • Install childproof devices to keep doors and windows secured.

  • Remove stove knobs or install safety knobs and an automatic shut-off on the stove.

  • Lower the temperature on water heaters.

  • Label medicines and keep them locked up.

  • Secure knives, lighters, matches, power tools, and guns. Keep these items out of reach.

  • Keep the house free from clutter. Remove rugs or anything that might contribute to a fall.

  • Remove objects that might break and hurt the person.

  • Make sure lighting is good, both inside and outside.

  • Install grab rails as needed.

  • Use a monitoring device to alert you to falls or other needs for help.

  • Reduce confusion.

  • Keep familiar objects and people around.

  • Use night lights or dim lights at night.

  • Label items or areas.

  • Use reminders, notes, or directions for daily activities or tasks.

  • Keep a simple, consistent routine for waking, meals, bathing, dressing, and bedtime.

  • Create a calm, quiet environment.

  • Place large clocks and calendars prominently.

  • Display emergency numbers and home address near all telephones.

  • Use cues to establish different times of the day. An example is to open curtains to let the natural light in during the day.  

  • Use effective communication.

  • Choose simple words and short sentences.

  • Use a gentle, calm tone of voice.

  • Be careful not to interrupt.

  • If the person is struggling to find a word or communicate a thought, try to provide the word or thought.

  • Ask one question at a time. Allow the person ample time to answer questions. Repeat the question again if the person does not respond.

  • Reduce nighttime restlessness.

  • Provide a comfortable bed.

  • Have a consistent nighttime routine.

  • Ensure a regular walking or physical activity schedule. Involve the person in daily activities as much as possible.

  • Limit napping during the day.

  • Limit caffeine.

  • Attend social events that stimulate rather than overwhelm the senses.

  • Encourage good nutrition and hydration.

  • Reduce distractions during meal times and snacks.

  • Avoid foods that are too hot or too cold.

  • Monitor chewing and swallowing ability.

  • Continue with routine vision, hearing, dental, and medical screenings.

  • Only give over-the-counter or prescription medicines as directed by the caregiver.

  • Monitor driving abilities. Do not allow the person to drive when safe driving is no longer possible.

  • Register with an identification program which could provide location assistance in the event of a missing person situation.

SEEK MEDICAL CARE IF:

  • You have new behavioral problems, such as moodiness, aggressiveness, or seeing things that are not there (hallucinations).

  • You have any new problem with brain function, such as balance, speech, or falling a lot.

  • You have problems swallowing.

  • You have a fever.

Small changes or worsening in any aspect of brain function can be a sign that the illness is getting worse. It can also be a sign of another medical illness such as infection. Seeing a caregiver right away is important.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have sudden weakness or numbness of the face, arm, or leg, especially on one side of the body.

  • You have sudden confusion.

  • You have trouble speaking (aphasia) or understanding.

  • You have sudden trouble seeing in one or both eyes.

  • You have sudden trouble walking.

  • You have dizziness.

  • You have a loss of balance or coordination.

  • You have a sudden, severe headache with no known cause.

  • You have new chest pain, angina, or an irregular heartbeat.