Frontotemporal Dementia (5%) = Pick Bodies

Question 1

Pathophysiology

Answer 1

Progressive degeneration of the frontal and/or temporal lobes associated with Pick bodies, with a number of subtypes such as Pick’s disease
In this condition there is atrophy of the fronto-temporal region, without the histology seen in Alzheimer’s.

Question 2

Clinical features

Answer 2

Speech and language affected mostly
E.g e.g. reduced fluency or comprehension = TEMPORAL more so affected
Thinking and memory affected mostly = FRONTAL
Behavioural and personality changes, e.g. impulsivity
Memory impairment

Question 3

Treatment

Answer 3

AChE inhibitors and memantine are not recommended
Supportive measures as discussed above is recommended
The drug rivastigmine may help to improve symptoms.

Question 4

Diagnostic criteria

Answer 4

Diagnostic criteria include two of:
- Visual hallucinations
- Parkinsonism
- Fluctuating mental state

Question 5

Risk factors

Answer 5

Family history = Autosomal dominant change in Tau protein (chromosome 17)
Family history of MND (TDP-43)