The importance of an early and accurate diagnosis: behavioral variant of frontotemporal dementia . Clinical aspects

• Published in: Bulletin of Integrative Psychiatry Vol. 27; no. 1; p. 115
• Main Authors: Grosu, Madalina Ionela, Rugina, Anina, Badii, Georgiana-Biatrice, Cristofor, Ana-Caterina
• Format: Journal Article
• Language: English
• Published: Institute of Psychiatry Socola, Iasi 01.03.2021
• Subjects: Delusional disorder; Delusions; Dementia; Nervous system diseases; Schizophrenia; Romania
• ISSN: 1453-7257

Frontotemporal dementia, a neurodegenerative disorder, is characterized by early onset with an outstanding impact on the patients' life. The most impressive alteration is the occurrence of behavioral manifestation which dominate the clinical picture throughout the entire evolution of the disease. Up to this date, early diagnosis of frontal-temporal dementia remains a challenge especially because it is associatiated with a wide range of symptoms, often perfectly mimicking affective or psychotic disorders. In recent years, positive diagnostic criteria for Frontotemporary Dementia have been nuanced in an attempt to improve the diagnosis process. The evolution of the disease is progressive, with a short survival span and a rapid decline of the patient's state, which represents a challenge for the caretakers in their attempt to provide the necessary care and the permanent supervision required in order to avoid accidents. A common dilema among clinical physicians is related to the prognosis of the illness, but, at present, there is not sufficient data in regard to this matter. The only factor with an impact on the survival prognosis is the presence of language disorders at the first assessment, which associates with a lower survival rate. This paper aims to emphasize once again the significance of a proper diagnosis by presenting a complex case of bvFTD which was quite challenging in terms of differential and positive diagnosis taking into consideration the unusual onset in the form of delusional disorder. Psychotic symptoms such as hallucinations and delusions, are well known to be main symptoms in schizophrenia but are also prominent features in several neurodegenerative diseases (e.g. Alzheimer's disease, dementia with Lewy bodies, psychosis in Parkinson's disease). Therefore, signs of actual bvFTD may often be misinterpreted. KEY WORDS: Frontotemporal dementia, behavioral manifestations.