Clinical aspects of frontotemporal dementia

Frontotemporal neurodegeneration can cause three typical clinical syndromes : frontotemporal dementia (FTD), primary progressive aphasia (PPA) and sema ntic dementia (SD), In the present paper we review these syndromes, highlig hting FTD, four case examples are presented. At the early stage of FTD chan ges of personality and social conduct are prominent, whereas cognitive func tions are relatively well preserved. Since the usual dementia tests are not sufficiently sensitive to disclose non-cognitive symptoms, clinical diagno sis as well as differentiation from non-organic psychiatric disorders can b e difficult. Detailed history, thorough clinical examination, and neuropsyc hological testing are required to establish the diagnosis, EEG and function al brain imaging may be helpful, The choice of therapeutic options for FTD is extremely limited. Medications may be used to treat neuropsychiatric sym ptoms, There is little experience with non-pharmacologic behaviour modifica tion and milieu treatment approaches. The problems that FTD imposes on care givers are dissimilar to those arising from Alzheimer's disease. Families r eceive little or no support so that early nursing home admission of patient s is common.