Frontotemporal dementia: From the clinic to the differential diagnosis

Abstract

Introduction: Frontotemporal dementia (FTD) is a disease that encompasses several syndromes that differ in their cognitive, behavioral, language signs, and motor phenomena. Only Alzheimer’s disease causes more early-onset dementia cases than FTD. According to World Health Organization (WHO) projections, dementia rates will double every 20 years and reach 115.4 million people in 2050, ranging from 3% to 26%. The FTD spectrum encompasses three variant syndromes, namely the behavioral variant, the semantic variant, and the non-fluent/agrammatical variant. Frontotemporal lobar degeneration is neuropathologically related to the clinical phenotypes of FTD. Therefore, the frontal and temporal lobes suffer from gliosis and selective neuronal loss due to this neurodegenerative condition. Case Report: A 62-year-old doctor with no comorbidities. According to the family, he reports delivering very slowly, which he doesn’t and comes in the processing very efficiently. He claims that he already lost on the street but managed to restore his visuospatial function. He denies changes in his daily life to recent trauma. Neurological examination revealed impaired attention and behavioral changes, impaired short-term memory (mini-mental: 19/30 points), normal laboratory, regular liquor; skull magnetic resonance imaging (MRI) showed mild atrophy in the frontotemporal regions. Decreased activity in areas of the cortex was observed by cerebral perfusion scintigraphy. Conclusion: Therefore, this report is relevant because it correlates a patient with neurological examination and tests with a good indication of FTD; however, the diagnosis can be confirmed with greater accuracy through brain perfusion scintigraphy. It is still possible to observe that although there has been a significant increase in the literature on FTD, its variants and its clinic still need further studies regarding their possible differential diagnoses, mainly related to psychiatric disorders and the behavioral variant of FTD.