Behavioral Variant Frontotemporal Dementia

Q: 67 years old male is admitted to ICU for a suicidal watch. Patient is lately noted to have increased compulsive behavior of hanging out on his balcony. He claims he read in a book that such acts is needed to enhance spirituality. The family also reported disinhibition with public urination, loss of empathy, and hyperorality. These behaviors are inclined to represent which dementia?

Answer: Behavioral variant of frontotemporal dementia (bvFTD)

Behavioral variant FTD (bvFTD) is the most common type of FTD. Patients are frequently referred to or misdiagnosed as psychiatric patients. The four major hallmarks of such dementia are

• public disinhibition 
• apathy and loss of empathy with loss of motivation and interest in social relationships
• hyperorality with a tendency to attempt to consume inedible objects
• compulsive behaviors like our patient in this question

#neurology

#psychiatry

References:

1. Peet BT, Castro-Suarez S, Miller BL. The Neuropsychiatric Features of Behavioral Variant Frontotemporal Dementia. Adv Exp Med Biol. 2021;1281:17-31. doi: 10.1007/978-3-030-51140-1_2. PMID: 33433866.

2. Boeve BF. Behavioral Variant Frontotemporal Dementia. Continuum (Minneap Minn). 2022 Jun 1;28(3):702-725. doi: 10.1212/CON.0000000000001105. PMID: 35678399; PMCID: PMC9578563.