Case Report: Catatonic Stupor in Behavioral Variant Frontotemporal Dementia

Area of Science:

• Neuroscience
• Geriatric Psychiatry

Background:

• Catatonia is a complex psychomotor syndrome associated with various neuropsychiatric disorders.
• Degenerative dementias can present with atypical symptoms, challenging diagnosis and treatment.

Observation:

• A 95-year-old woman exhibited personality changes including sexual disinhibition, aggression, and progressive psychomotor decline.
• Symptoms evolved to include stereotypies, gait deterioration, incontinence, mutism, and refusal of care.
• Standard treatments like benzodiazepines, olanzapine, and electroconvulsive therapy were ineffective.

Findings:

• Magnetic resonance imaging revealed asymmetric frontotemporal, parietal, and upper brainstem atrophy.
• The patient's condition progressed over seven years, culminating in sepsis and death from stupor.
• The findings suggest a correlation between frontotemporal injury and initial behavioral changes, and parietal cortex degeneration and catatonic stupor.

Implications:

• This case contributes to the limited understanding of catatonia as a symptom of degenerative dementia.
• It supports the hypothesis that parietal cortex damage can lead to pathological avoidance, with catatonic stupor as an extreme manifestation.