Frontotemporal dementia

Case contributed by A.Prof Frank Gaillard

Presentation

12-month rapid progression of inappropriate behaviour, hyperorality, stereotyped behaviour, executive impairment, apathy, lack of empathy, poor personal care and reduced verbal output, with UMNL (hyperreflexia, clonus), LMNL (muscle atrophy, reduced gag reflex) and positive glabellar tap.

Patient Data

Age: 45 years
Modality: MRI

Prominent bilateral frontal lobe atrophy with preservation of the rest of the brain. No microhaemorrhages or abnormal diffusion. 

Modality: Nuclear medicine

RADIOPHARMACEUTICAL: 99mTc ECD, 512 MBq

TECHNICAL PROCEDURE AND RESULTS SPECT

Studies of the brain were performed. There is severe hypoperfusion of the frontal lobes with mild-to-moderate hypoperfusion of the temporal lobes and mild parietal hypoperfusion. Perfusion is preserved to the cerebellum, primary visual cortex and basal ganglia. No other significant abnormalities are seen.

CONCLUSION: The findings are consistent with frontotemporal dementia.

Case Discussion

Both MRI and SPECT support the clinical diagnosis of a behavioural variant of frontotemporal dementia. The diagnosis is further consolidated by EMG which support the possibility of FTD-associated motor neuron disease.

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Case Information

rID: 50049
Case created: 16th Dec 2016
Last edited: 26th Dec 2016
Inclusion in quiz mode: Included

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