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Posterior Cortical Atrophy — SCE Neurology MCQ

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HardNeurodegenerative DiseasePosterior Cortical AtrophySCE Neurology

A patient has progressive executive dysfunction, apathy, loss of empathy, sweet-food craving and stereotyped routines, with relative early preservation of episodic memory. MRI shows frontal and anterior temporal atrophy. Which diagnosis best fits?

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Correct answer: D — Behavioural-variant frontotemporal dementia, given the imaging pattern

The best answer is “Behavioural-variant frontotemporal dementia, given the imaging pattern”. The early behavioural syndrome and frontotemporal-predominant atrophy fulfil the core bvFTD pattern. “Typical amnestic Alzheimer disease” is plausible in a different neurological context, but the decisive findings here argue against it. “Posterior cortical atrophy” is plausible in a different neurological context, but the decisive findings here argue against it. “Dementia with Lewy bodies” is plausible in a different neurological context, but the decisive findings here argue against it. “Subcortical vascular cognitive impairment” is plausible in a different neurological context, but the decisive findings here argue against it.

Reference: International consensus criteria for behavioural-variant frontotemporal dementia: https://pmc.ncbi.nlm.nih.gov/articles/PMC3170532/