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A 29-year-old woman was referred to a community hospital. She was accompanied by her parents. They reported that behavioral and personality changes had been present for 3 days. The patient suddenly had started to speak almost incomprehensibly. She also had become obtrusive and impulsive. In addition, she had talked to imaginary people and introduced herself as another person. The physicians at the hospital described her as an aggressive person with incoherent thinking, pathological crying, and hallucinations. No focal neurological signs were observed. With suspected schizophrenic psychosis, the patient was transferred to a psychiatric department.
This chapter talks about a 50-year-old man who was referred for dementia evaluation a few months after losing his job as head of a department in a large company. An MRI scan was initially described with white matter lesions in the temporal and parietal lobes, but no focal atrophy. A revised report also described cortical atrophy of the frontal lobes. The diagnosis of the Frontotemporal Dementia (FTD) was given based on the dominant clinical symptoms that had developed gradually over a couple of years: apathy, disinhibition, loss of social conduct, impaired empathy, stereotypic behavior, neglect of self-care, altered eating pattern, and impaired insight. Frontotemporal Lobar Degeneration (FTLD) is used here as the general label for neurodegenerative diseases involving primarily the anterior regions of the brain. The patient presented here is a prototypical example of the behavioral variant of FTLD, exhibiting most of the characteristic features of this clinical subtype.