[Frontotemporal dementia: behavioral story of a neurological disease]

The very slow progression of behavioral disorders, initially isolated at the onset of frontotemporal dementia, easily results in their neglect, all the more so since the patients are anosognosic. In absence of cognitive decline, these patients, whatever carrying a neurological disease, are frequently led towards psychiatrists. Many psychiatric disorders may be evoked: depression, mania, compulsive obsessive disorder, psychopathy, alcoholic addiction, bulimia, schizophrenia, or Diogene syndrome. However, the diagnosis can often be easily corrected by a detailed clinical analysis. The knowledge of the 3 behavioral symptoms included in the diagnostic criteria can help to recognize frontotemporal dementia, even when imaging and neuropsychological data show mild abnormalities. In the last few years, various neuropsychological, biological and environmental mechanisms have been proposed to explain the behavioral disorders. These disorders are very difficult to tolerate by the caregivers because the patients appear to be asocial and show no affect. A detailed information of the changes related to the disease is important for the caregivers to accept the behavioral changes and to cope with them. However, over time, the occurrence of mutism may lead caregivers to regret the period of behavioral disorders.