Trichotillomania Ranging from "Ritual to Illness" and as a Rare Clinical Manifestation of Frontotemporal Dementia: Review of Literature and Case Report

International Journal of Trichology
Thomas Gregor IssacSadanandavalli Retnaswami Chandra

Abstract

Frontotemporal dementia (FTD) is the most common form of dementia in the younger age group and often exists with comorbid obsessions and compulsions in up to 80% of the patients. Trichotillomania or compulsive "hair-pulling" disorder is a rare manifestation of FTD and is a poorly evaluated symptom in this condition. The release of "grooming functions" due to frontal disinhibition is often attributed to the evolutionary perspective; however, recent findings also implicate the role of neurotransmitter dysfunction. Trichotillomania is currently classified under obsessive and compulsive behavioral spectrum disorders and is often encountered in the younger population with research evidence of response to selective serotonin reuptake inhibitors (SSRIs), antipsychotics, and newer drugs such as N-acetyl cysteine. The role of behavioral therapy also has robust evidence in trichotillomania. We herewith report the case of a middle-aged male patient who presented with features of personality change and behavioral problems in terms of anger, agitation, and disinhibitory behavior who on detailed clinical evaluation and radiological assessment had features consistent with behavioral variant of FTD along with compulsive "hair plucking" behavio...Continue Reading

Citations

Dec 13, 2018·The Journal of Neuropsychiatry and Clinical Neurosciences·Negar MohebMario F Mendez

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