OVERVIEW
Overview of frontotemporal dementia
Frontotemporal dementia is a heterogeneous group of diseases characterized by frontotemporal lobar atrophy and cognitive changes, and is the second most common early-onset degenerative dementia after Alzheimer’s disease.
Whether medical insurance
Yes
Department
Neurology, Psychiatry
Clinical symptoms
The disease starts insidiously and progresses slowly. Personality and affective changes as early symptoms, with progressive behavioral abnormalities and unremarkable memory and visuospatial symptoms, or progressive language disorders (few words, poor vocabulary, stereotypy and mimicry).
Hazards
As the disease progresses, in addition to overt dementia, common comorbidities for patients include aphasia, depression, and severe mental behavioral abnormalities.
Complications
Aphasia, depression, pulmonary infection, urinary tract infection, etc.
Examination
CT, MRI, single photon emission computed tomography, etc.
Diagnosis
Diagnosis can be made by behavioral, emotional, and personality changes as early symptoms, while memory and visuospatial symptoms are not obvious, or by progressive language disorders, combined with CT, MRI, and single-photon emission computed tomography showing asymmetric atrophy of the frontal and/or temporal lobes.
Therapeutic principles
There is no specific treatment for this disease, and medications can be used to improve the behavioral symptoms of frontotemporal dementia.
Curability
Patients mostly die from complications.
Dietary recommendations
Diet should be regular, small and frequent, and light, soft and easily digestible food should be given.
Causes
Etiology
The etiology is not yet clear and the pathogenesis is unclear. It may be idiopathic degenerative changes of the cytosol, or axonal injury secondary to cytosolic changes. About 20% of patients with frontotemporal dementia have mutations in the tau protein gene.
Symptoms and Diagnosis
Typical Symptoms
Early manifestations of frontotemporal dementia include decreased ability to interact, personality and emotional changes, such as irritability, irritability, apathy and depression, and gradual behavioral abnormalities, such as inappropriate demeanor, lack of aggressiveness, indifference to things, and impulsive behavior. Excessive mouth activity, gluttony, obesity, putting anything into the mouth to test it, with forgetfulness, aphasia, inability to think. Little speech, poor vocabulary, stereotyped and imitated language to the point of muteness, sense of somatic abnormality and fragmentary delusions, lack of hygiene, etc.
Other symptoms
Patients may develop primitive reflexes such as sucking reflex and strong grip reflex, incontinence, hypotension and blood pressure instability. Some may have Parkinson’s syndrome manifestations such as decreased movement, muscle tonus and tremor, and some may have muscle weakness and atrophy.
Diagnostic basis
Behavioral and personality changes as early symptoms, while memory and visuospatial symptoms are not obvious, or characterized by progressive language disorders. EEG examination is mostly normal in early stage, and a few patients can see decreased wave amplitude and reduced α wave, and in late stage, low background activity, minimal or no α wave, irregular medium amplitude δ wave, and sharp wave in a few patients.CT and MRI examination can see characteristic limited frontal and/or temporal lobe atrophy, narrowing of cerebral gyrus, wide sulcus and frontal horn with ballooning enlargement, thinning of frontal and anterior temporal poles, enlargement of temporal horn, and widening of lateral fissure pool, which is mostly asymmetric. that can be seen in the early stages of the disease. Single photon emission computed tomography showed asymmetric reduction of blood flow in the frontal and temporal lobes. The diagnosis is made on the basis of the typical presentation and examination findings.
Treatment
Therapeutic approach
There is no specific treatment for this disease, but medications can be used to improve the behavioral symptoms of frontotemporal dementia.
Medications
5-hydroxytryptamine selective reuptake inhibitors can treat behavioral symptoms of frontotemporal dementia, such as depression, compulsive movements, and overeating. For aggressive behaviors, olanzapine is more effective with lisperidone.
Prognosis.
Patients mostly die from complications.
Nursing care
Daily care
1. do psychological care, maintain the patient’s dignity. 2. pay attention to personal hygiene, keep clean, prevent infection. 3. follow the doctor’s instructions, take medication on time and according to the dosage.
Dietary management
1. Diet should be regular, small and frequent, avoid overfilling. 2. Eat light, soft, easy to digest, low-fat food, high protein, high vitamin, lecithin-rich foods. 3.