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Frontotemporal Dementia — RACP Adult Medicine MCQ

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ModerateNeurologyFrontotemporal DementiaRACP Adult Medicine

A 60-year-old man presents with personality change, disinhibition, social inappropriateness, and repetitive behaviours. Language is relatively preserved initially. MRI shows bifrontal and bitemporal atrophy. Family history reveals his mother had similar symptoms at age 62. What is the most likely diagnosis?

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Correct answer: E — Frontotemporal dementia

Early personality change, disinhibition, social inappropriateness with relative preservation of memory and visuospatial function, and frontal/temporal atrophy on MRI is characteristic of behavioural variant FTD. Approximately 40% have a positive family history (C9orf72 expansion, MAPT, GRN mutations). No disease-modifying treatment exists; management is symptomatic.

Reference: Rascovsky 2011 bvFTD Criteria; eTG Neurology 2024