Abstract
We present the case of a patient with an atypical course of frontotemporal lobar degeneration (FTLD) complicated by the use of an anticholinergic drug. A 70-year-old patient, followed by psychiatrists for depression and behavioral disorders, received a diagnosis of dementia with Lewy bodies (DLB) at another Center due to auditory hallucinations, gait impairment, and tendency to fall. He was then admitted to our Memory Clinic Unit for behavioral disturbances, such as delusional thinking, auditory hallucinations, and memory complaints. At that time, the patient's therapy included Lorazepam, Quetiapine, Promazine, and Biperiden. The latter was immediately suspended for the absence of extrapyramidal signs and to avoid the anticholinergic cognitive side effects. A 18F-FDG PET showed a derangement of cortical metabolism with diffusely reduced activity, and limited areas of hyperactivity involving lateral frontal and lateral temporal inferior regions bilaterally. The patient underwent a series of exams, including neuropsychological tests, 123I-MIBG scintigraphy, cerebrospinal fluid examination, and genetic analysis. A second 18F-FDG PET showed an extensive remodulation of metabolic activity: relative higher concentration of the tracer...Continue Reading
References
Aug 1, 1988·Archives of General Psychiatry·J B Williams
May 1, 1994·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·S E MolchanT Sunderland
Aug 1, 1996·Italian Journal of Neurological Sciences·A R GiovagnoliE Capitani
May 1, 1997·Neurology·J L Cummings
Dec 17, 1998·Neurology·D NearyD F Benson
Mar 9, 1999·Life Sciences·Y SudoM Matsushita
Feb 2, 2002·The British Journal of Psychiatry : the Journal of Mental Science·Julie S SnowdenDavid M A Mann
Aug 23, 2003·Annals of Nuclear Medicine·Hideki KobayashiNorio Mitsuhashi
Nov 2, 2004·Annals of Nuclear Medicine·Junichi TakiNorihisa Tonami
Jul 5, 2005·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·I AppollonioP Nichelli
Jan 13, 2009·Neurobiology of Aging·Fabiana NovellinoAldo Quattrone
Aug 12, 2009·Neurology·C R McDonaldUNKNOWN Alzheimer's Disease Neuroimaging Initiative
Jul 1, 2009·Therapeutic Advances in Neurological Disorders·Helmar C LehmannHans-Peter Hartung
Jun 20, 2014·Lancet Neurology·Raffaele FerrariParastoo Momeni
Jun 26, 2014·Seminars in Neurology·Elissaios Karageorgiou, Bruce L Miller
May 11, 2015·Biological Psychiatry·Daniela GalimbertiElio Scarpini
Feb 26, 2016·Lancet Neurology·Francesc GrausJosep Dalmau
Aug 29, 2016·Journal of Alzheimer's Disease : JAD·Marianne ChapleauSimona M Brambati
Apr 16, 2017·Neurologic Clinics·Nicholas T OlneyBruce L Miller
Jun 9, 2017·Neurology·Ian G McKeithKenji Kosaka
Jun 18, 2017·Nature Reviews. Neurology·Lieke H MeeterJohn C van Swieten
Jul 12, 2017·European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology·Claudia VingerhoetsTherese A M J van Amelsvoort
Oct 17, 2017·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Luigi ZulianiBruno Giometto
Feb 10, 2018·Acta Neuropathologica Communications·Bradley R GrovemanByron Caughey
Jul 28, 2018·Journal of Internal Medicine·K Blennow, H Zetterberg
Oct 5, 2018·Journal of Alzheimer's Disease : JAD·Michele FioriniGianluigi Zanusso
Oct 11, 2019·Annals of Clinical and Translational Neurology·Matilde BongianniGianluigi Zanusso
Dec 24, 2019·Frontiers in Neuroscience·Jorge López-ÁlvarezLuis Agüera-Ortiz