[Frontotemporal dementia with cortico-basal syndrome]

Area of Science:

• Neurology
• Neuroscience
• Clinical Medicine

Background:

• Frontotemporal dementia (FTD) encompasses neurodegenerative diseases causing progressive behavioral and speech deficits, linked to frontal/temporal lobe pathology.
• International trials have established diagnostic criteria for clinically 'possible/probable' FTD subtypes.
• Corticobasal syndrome (CBD) is a rare FTD subtype characterized by specific neurological and cognitive impairments.

Observation:

• A 60-year-old male presented with a two-year history of speech impairment and memory decline.
• Neurological examination revealed 'frontal' syndrome (efferent motor aphasia, agnosia, dysgraphia) and 'corticobasal syndrome' (dyspraxia, alien hand syndrome).
• MRI showed frontotemporal neurodegeneration with frontal and temporal lobe atrophy.

Findings:

• The patient was diagnosed with clinically 'probable' FTD based on clinical presentation, history, and MRI findings.
• The case highlights the diagnostic challenges and specific clinical features of CBD within the FTD spectrum.
• This diagnosis underscores the importance of identifying FTD subtypes for appropriate therapeutic strategies.

Implications:

• Accurate FTD subtype diagnosis guides neurologists in patient management and pharmacologic treatment selection.
• Unlike Alzheimer's disease, cholinesterase inhibitors are not recommended for FTD.
• Treatment standards for FTD should focus on antipsychotics, SSRIs, and anxiolytics with nootropic effects for behavioral and affective symptoms.