Michael Geschwind, MD, PhD, FAAN, Memory and Aging Center, University of California, San Francisco, CA, introduces the concept of rapidly progressive dementia (RPD), discussing several possible etiologies. No consensus definition for this condition exists, however, from anecdotal experience, Dr Geschwind considers a patient to have RPD if their normal cognition declines to dementia within weeks or months, with a cut-off of two years. Prion diseases, autoimmune diseases, and infections are some commonly identified causes, with Creutzfeldt-Jakob disease (CJD) representing the prototype of RPD. The VITAMINS pneumonic can aid physicians in considering all the possible etiologies of RPD, some of which may mean a patient is completely treatable or curable. Dr Geschwind discusses where his interest in the field of RPD originated, highlighting how he discovered the unmet need for the education and training of neurology professionals on the work-up of patients with the condition. As emphasized by Dr Geschwind, there is a need for better teaching at all levels of medical education and improved diagnostic tools, for example, diffusion-weighted MRI for the detection of prion disease. This interview took place at the 18th Annual Congress on Controversies in Neurology (CONy 2024) in London, UK.
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