History
A 45 year-old female has short-term memory loss, behavior changes, increased irritability/agitation/confusion, motor weakness, and coordination problems. MRI and PET were performed. What is the likely diagnosis?
Findings
FDG-PET showed decreased metabolic activity in both frontal lobes and temporal lobes. MRI imaging showed degenerative changes in both frontal lobes and anterior temporal lobes.
Diagnosis
Frontotemporal Dementia
Discussion
Froontotemporal lobar degeneration (FTD) is a heterogenous group of diseases involving the frontal and anterior temporal lobes leading to dementia in a younger group of patients. FTD has three types: Pick's disease, sementic dementia, and progressive non-fluent dementia. In the early stages, the patients have transient neurological, emotional, and behavioral changes with dementia at later stages. There is decreased FDG metabolism in the frontal and anterior temporal lobes on PET imaging. In majority of these patients, there is no amyloid deposit where it can be differentiated from Alzhimer's disease.
DDx
Dementias of Lewy body, Alzheimer's disease
Key points
Neurological exam and review of the treatable conditions such as depression, alcohol, and drug abuse and medical co-morbidities are the 1st line of therapy. Imaging such as carotid ultrasound and vascular flow to brain such as MRA are key for the structural changes of the brain. PET FDG and Tau imaging can differentiate different types of dementia.
References
Structural brain imaging in fronto temporal dementia, (BBA)-Molecular basis of disease, Vol 1822, March 2012
PET approaches for diagnosis of dementia, K. Ishii, AJNR, Am J Neuroradiology, 2014
Move your cursor vertically to scroll through the images ( shortcut : S )
Move your cursor vertically to change brightness and horizontally to change contrast ( shortcut : W )
Move your cursor vertically to zoom in and out ( shortcut : Z )
Move your cursor to drag the images ( shortcut : M )
Move your cursor to draw and measure the pixels/mm of each image ( shortcut : D )
Move your cursor to measure the angle between two lines ( shortcut : A )
Toggle the display of annotations
Toggle 1, 2 or 4 series active on the same viewer ( shortcut: 1, 2, 4 )
Affect all active series at once
Toggle fullscreen mode ( shortcut : F )
Reset all the active series to their default parameters ( shortcut : R )
Pinch to zoom in and out.
Slide with two fingers to move a serie's images.
Loading comments ...