27th National Clinical Education Symposium Presentation Abstracts
29 APRIL 2025, MONDAY
13:00-14:00 POSTER PRESENTATION SESSION-2
A Case Of Frontotemporal Dementia
Sultan Tomaç1
-
Show more (Affiliations)
1. Ruh Sağlığı ve Hastalıkları, Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, İstanbul
DOI: 10.5080/kes27.abs135 Page 161
OBJECTIVE:Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by progressive impairments in behavior, executive function, or language. It primarily affects individuals under 65 years of age. This case aims to highlight how FTD can be confused with depression. CASE (The patient consent must be provided and specified with appropriate terms.):Casereport:A 52-year-old male patient, married and with an elementary school education, was brought to the emergency department with complaints of reduced appetite, behavioral changes, social withdrawal, aggression, and decline in self-care over the past six months. The patient's Hamilton Depression Rating Scale (HAM-D) score was 21, suggesting depression. He was admitted to the psychiatry department and started on sertraline 25mg/day. The first symptoms were apathy and changes in behavior, including aggression toward his wife, collecting cardboard from trash bins, and even starting fires at work. He exhibited strange eating habits, only consuming snacks like chips and nuts. There was no family history of neurodegenerative or psychiatric diseases, and lab results were normal. Neurological examination revealed poor orientation, inappropriate behavior, and cachectic appearance. MRI of the brain showed significant volume loss in the orbitofrontal cortex and anterior temporal lobes, with atrophy in the hippocampus and cerebellum. The diagnosis was behavioral variant FTD. Despite no improvement in his symptoms, sertraline was continued, and olanzapine 10mg/day and donepezil 5mg/day were added. Follow-up outpatient visits continued post-discharge. DISCUSSION:Psychiatric disorders can mimic frontotemporal dementia. The most prominent early signs of behavioral variant FTD are personality changes, disinhibition, and apathy, which can easily be confused with depression. Careful differential diagnosis is essential and requires a detailed history, family background, neuropsychological testing, laboratory workup, and neuroimaging to distinguish FTD from other conditions. This case emphasizes the importance of excluding organic pathology early in the diagnostic process. Referencess:Bang, J., Spina, S., & Miller, B. L. (2015). Non-Alzheimers dementia 1: Frontotemporal dementia. Lancet (London, England), 386(10004), 1672.