Case study of Fronto-temporal lobe involvement

Resolved question:
Could you help me figure out this case study? I summarized it below:

Patient F.G. was a 62 year-old woman who presented herself with many signs of a neurological disorder. Many of the concerns were mostly from her husband who had observed many personality changes for the past 6-8 months. F.G. presented herself with an unkempt appearance, and her husband noticed her concern for her appearance had declined in the past year. During her initial examination, she was tangential with questions asked and impulsive when given tasks. Another sign she presented at the clinic was difficulty remembering items over a brief delay. She had difficulty recalling a more extensive word list after a 20-minute delay and reproducing a 2-dimensional complex figure from memory after a 30-minute delay. Her memory performance was improved when a cue was given, and her recognition performance was normal. According to her husband, F.G. is still organized at home to help her remember dates and locations of important objects. Her husband is more concerned with F.G. being more irritable and compulsive. She was spending money frivolously and was being verbally combative with salespeople. F.G.’s bridge group asked her to stop attending because she was using expletives and making offensive remarks, and she did not seem concerned with the consequences of her actions. The potential syndromes that F.G. might have after assessing the signs are

Submitted: 4 Days
Category: Neurologist, Medical

Expert:  Dr. Sudhir Kumar replied 4 Days.

Hello, Thank you for posting your query at DoctorSpring.com.

I have gone through the case study in detail.

This 62-year old woman has cognitive dysfunction, with predominant involvement of frontal and temporal lobes. Changes in personality, impulsive nature, lack of inhibition (disinhibition), lack of insight into the illness, are all suggestive of bilateral frontal lobe involvement.

At the same time, involvement of memory is a sign of temporal lobe involvement. Improvement of memory with cues could indicate a sub-cortical involvement.

These findings are suggestive of dementia. The most likely cause of dementia in this case could be fronto-temporal dementia (FTD), Pick's disease and Alzheimer's disease.

I hope it helps. Please get back if you have any more queries.

Best wishes,

Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist

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