Presentation
Loss of consciousness with eye rolling.
Patient Data
No evidence of intracranial hemorrhage or infarct.
Bilateral severe frontotemporal gyral atrophy, more prominent on the left. Grossly dilated frontal horns of the lateral ventricles (left considerably more than right) and temporal horns.
PET-CT
A PET CT was obtained 6 years earlier (images unavailable):
Indication: behavioral changes.
Findings: Dilated ventricles and sulci, more prominent on the left and very significant for the patient's age. The PET scan shows a severe decrease in radiotracer uptake in the left frontal lobe and a significant if less severe decrease in the left parietotemporal lobes. Moderate to severe decrease in uptake in the right frontoparietal lobes and moderate decrease in the right temporal lobe. Mildly decreased uptake in the right cerebellar hemisphere. Good uptake in the basal ganglia and thalami.
Case Discussion
Behavioral variant frontotemporal dementia (bvFTD), diagnosed 5 years earlier. Lives with a live-in.
Declining cognitive function: forgets things from moment to moment, does not answer to the point, talks less, has difficulty expressing himself, repeats phrases and questions. Food is brought to his apartment twice a day, lest he eat unstoppably. Walks in circles incessantly. Problems with continence.
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