Delusions and Hallucinations in Frontotemporal Dementia

Department of Clinical Neurological Sciences, Division of Neurology, St Joseph's Hospital, University of Western Ontario, Ontario, Canada.
Cognitive and behavioral neurology: official journal of the Society for Behavioral and Cognitive Neurology (Impact Factor: 0.95). 07/2008; 21(2):107-10. DOI: 10.1097/WNN.0b013e3181799e19
Source: PubMed


Frontotemporal dementia (FTD) is associated with marked behavior changes, but hallucinations and delusions are rare.
To report a case of FTD with early and persistent delusions, including de Clerambault syndrome.
We describe the clinical, neuroradiologic, and neuropathologic findings of a 76-year-old woman with an 11-year course of FTD with bizarre delusions and hallucinations.
The patient's autopsy examination of the brain revealed pathology consistent with frontotemporal lobar degeneration with ubiquitin-positive and transactive response (TAR)-DNA-binding protein-43-positive inclusions and hippocampal sclerosis.
Delusions and hallucinations can occur in proven frontotemporal pathology.

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Available from: Maria Carmela Tartaglia
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    • "When considering the occurrence of delusions, strict associations were found with GM volumes in the hip- pocampus. This region has already been reported as implicated in the generation of delusions in patients with schizophrenia [79] [80] [81], fronto-temporal dementia [82], and temporal lobe epilepsy [83]. Misidentification of person, places, or objects, in association with delusional memories and content-related confabulations were the types of delusions detected, by NPI-12, in our study. "
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    • "The presence of visual hallucinations is considered a key element in the clinical diagnosis of LBD, representing one of the core features in the diagnostic criteria for LBD. Albeit rarely, delusions and hallucinations have been reported in FTD patients (Tartaglia et al., 2008; Le Ber et al., 2006), and their presence may sometimes lead to an erroneous diagnosis of LBD, in particular when Parkinsonian symptoms are associated. Recent studies showed that both sporadic and familial FTD patients with PGRN mutations can have an atypical clinical presentation (Rademakers et al., 2007) with early visual hallucination in 25% of cases (Le Ber et al., 2008), suggesting that the presence of hallucinations may help differentiate PGRN mutation carriers from others FTD patients (Le Ber et al., 2008). "
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