Frontotemporal Dementia – Behavioural Variant — SCE Neurology MCQ

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HardNeurodegenerative DiseaseFrontotemporal Dementia – Behavioural VariantSCE Neurology

Over three years, a 61-year-old develops disinhibition, loss of empathy, compulsive sweet eating and executive dysfunction with relatively preserved episodic memory. MRI shows frontal and anterior temporal atrophy. What is the diagnosis?

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Correct answer: C — Behavioural-variant frontotemporal dementia

The best answer is “Behavioural-variant frontotemporal dementia”. Early progressive behavioural change, loss of social cognition, stereotyped eating and executive dysfunction with frontotemporal atrophy form the characteristic bvFTD syndrome. “Typical amnestic Alzheimer disease” is less appropriate because typical Alzheimer disease begins with prominent episodic-memory impairment “Dementia with Lewy bodies” is less appropriate because Lewy body disease features fluctuations, visual hallucinations, REM-sleep behaviour disorder and parkinsonism “Major depressive disorder alone” is less appropriate because depression does not explain progressive disinhibition and focal atrophy “Normal ageing” is less appropriate because the functional and personality decline exceeds normal ageing

Reference: NICE NG97: Dementia — recommendations. https://www.nice.org.uk/guidance/ng97/chapter/Recommendations