engleski

Social behaviour vs. psychiatric features of frontotemporal dementia : case report

Most patients with frontotemporal dementia (FTD) present with socially inappropriate behaviour, poor insight and disinhibition. They often, however, are undiagnosed or misclassified as psychiatric patients, because in the absence of cognitive deficits. We present a 77-year-old man with pathologic tendency to collect items and storage objects in his apartment. He had dirty, untidy home and a filthy personal appearance about which he showed no shame. He tends to be aloof. He completed technical college, was married twice. He was followed for 2 years. His father had dementia of late onset. On examination, the patient was talkative with fluent speech. Comprehension was normal. No symptoms of psychosis or affective disorders were observed. MMSE was normal (29/30). On Brief neuropsychological cognitive examination he showed moderate cognitive decline (18/30). He scored in the normal range on tests of visuospatial skills. On word fluency test he was able to generate seven correct words in one minute. CT scan revealed both sided frontotemporal atrophy and broader Sylvian fissure. SPECT showed no changes significant for FTD. Except for the presence of palmomental and snout reflexes, the neurologic exam was normal. The rest of tests were normal. We present a FTD case with behavioural changes consistent with a frontal lobe personality syndrome. Deficits in verbal processing abilities and word finding difficulty stemming may contribute to the decreased memory performance. The lack of psychotic symptoms in FTD may indicate that the temporal-limbic system is necessary to develop psychotic symptoms.

frontotemporal dementia; social behaviour; psychiatric features

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