A case of frontotemporal dementia that was monitored long term as a misdiagnosis of depression

Yildirim S, Inanli I, Uygur H, Akyildiz A, Eren I

A case of frontotemporal dementia that was monitored long term as a misdiagnosis of depression

Frontotemporal dementia (FTD) is a focal clinical syndrome characterized by profound changes in personality and social conduct and associated with circumscribed degeneration of the prefrontal and anterior temporal cortex. Frontotemporal dementia, which is a highly heterogeneous disorder in terms of its clinical and neuropathological characteristics, is one of the neuropsychiatric disorders Therefore some cases with frontotemporal dementia might receive psychiatric diagnoses like depression, bipolar disorder, schizophrenia and Obsessive compulsive disorder. The present case describes a female patient with FTD that followed by treatment of depression for nearly 5 years although not being response. A 64-year-old female was brought to our clinic by her husband because of indifference, impairment in personal hygiene (urinary and fecal incontinence), perseverative response only to the questions asked. The patient’s symptoms, which were less talk, social withdrawal, apathy have started about seven years ago and was followed by depression for five years. The patient, who discontinued his treatment because of increasing his clinical symptoms 2 years ago was admitted to our clinic with a diagnosis of preliminary diagnosis FTD. During the psychiatric evaluation, we have made a detailed examination and imaging. Due to bilateral frontal and temporal lobes atrophy by magnetic resonance imaging (MRI) and hypometabolism in bilateral frontal and temporal regions by positron emission tomography using şuorodeoxyglucose (FDG-PET), she was diagnosed as FTD. Supportive treatment was recommended. FTD is the second most common cause of early onset dementia and is clinically characterized by progressive behavioral change, executive dysfunctions, and language difficulties. Clinical features of FTD include changes of personality, restlessness, loss of inhibition, apathy, social withdrawal and impulsiveness. FTD is separated from other dementias due to beginning psychiatric symptoms earlier than memorial impairment. In our case, although clinical symptoms were consistent with FTD, the patient was firstly diagnosed as having depression and has been followed for 5 years whereas her clinical symptoms became got worst. There was no differential diagnosis of FTD. Patients with FTD are frequently misdiagnosed as suffering from psychiatric conditions, mostly depression. Our case is important due to FTD was misdiagnosed with depression. Our case has been monitored for 5 years with a misdiagnosis of depression but it is an important case since it was not evaluated in detail despite being compatible with FTD.