An Indonesian elderly with primary progressive aphasia and behavioral variant of frontotemporal dementia: A case report and review article

Abstract

Background: Frontotemporal dementia (FTD) or Pick's disease, is the second most frequent cause of primary degenerative dementia in those between 55 and 65 years old.

Case presentation: A 57-year-old Indonesian female reported family that six months until one year prior to the presentation of her first symptoms, the patient had problems with memory, particularly short-term memory loss, with the patient unable to remember the task she was doing on time. The electroencephalogram revealed slowing background cerebral activity and diffuse slowing activity, indicating encephalopathy diffuse moderate state. CSF showed no pleocytosis and no elevated CSF Protein, but we did not perform tau level. She underwent brain magnetic resonance imaging (MRI) because of her aggression and impulsiveness. Brain MRI was notable for bilateral frontal and temporal atrophy. Incidentally, there was the leptomeningeal enhancement of the bilateral frontotemporal lobe. The patients were administered Haloperidol 0.5 mg orally twice daily, Donepezil 5 mg oral once daily, Aripiprazole 2.5 mg once daily, and Memantine 10 mg twice daily. The patient was discharged one week after admission and was started on antiviral therapy Acyclovir 800 mg 5 times a day for 14 days. The patient had shown more cooperative and less agitative.

Discussion: We report that FTD aims to help improve effective management.

Conclusion: Awareness of FTD needs to be increased even though this case is sporadic because it does not demand the possibility of this case occurring at a young age.

Keywords: Abnormal behavior; Dementia; Frontotemporal; Mental health.

Fig. 1

The electroencephalogram: slowing background cerebral activity and diffuse slowing activity.

Fig. 2

Bilateral prefrontal cortex atrophy and insular cortex atrophy.

Fig. 3

Bifrontal temporal atrophy.