Occasional patients with senile or presenile dementia respond favorably
to steroid therapy. In addition to endocrinopathy and increased
intracranial pressure, inflammatory processes and vasculitides can cause
dementia and be sensitive to steroids. The author reports four such cases.
A brain biopsy can be of great value for definitive diagnosis; it should be
considered particularly in unusual, fulminant, and unexplained cases of
dementia. A trial course of several weeks of steroid therapy can be given
for such cases, but steroids should not be continued if improvement is not