Frontotemporal dementia

Case contributed by A.Prof Frank Gaillard

Presentation

Inappropriate behaviour and difficulty at work, resulting in job loss.

Patient Data

Age: 30 years
Gender: Male

MRI brain

Modality: MRI

MRI demonstrates marked frontal and temporal atrophy, more marked on the right. There is also reduction in the caudate head size, again more pronounced on the right. Hippocampal volumes appear preserved. 

SPECT

Modality: Nuclear medicine

Studies were performed following sedation administered in the ward for difficult behaviour. 

SPECT studies performed following infusion of technetium HMPAO with mental stimulation and these of low statical quality but appear to show mildly but extensive reduced perfusion to the frontal lobes, particularly along the mesial surfaces. Elsewhere perfusion appears normal, in particular the posterior cingulate and precuneus hot zones are detected hence excluding an early Alzehmeir's disease. There is also hypoperfusion of the caudate heads bilaterally suspicious of Huntington's chorea, perfusion of the other basal ganglia, brainstem and cerebellum is normal.

Impression: Overall impression would favour a frontal impairment or dementia as the cause of the patient's behaviour. 

Case Discussion

Features of frontal and temporal atrophy, asymmetric, with caudate head volume loss are consistent with the clinical impression of a frontotemporal dementia

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Case Information

rID: 14321
Case created: 14th Jul 2011
Last edited: 9th Jan 2016
Inclusion in quiz mode: Included

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