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diagnostic criteria for frontotemporal dementia
Essential features:
1) insidious onset & gradual progression
2) early decline in social interpersonal conduct
3) early impairment in regulation of personal conduct
4) early emotional blunting
5) early loss of insight
Supportive features:
1) behavior
a) decline in personal hygiene & grooming
b) mental rigidity & inflexibility
c) distractability & impersistence
d) hyperoral behavior & dietary changes
e) perseveration & stereotypy
2) speech & language
a) lack of spontaniety & economy of speech
b) echolalia
c) mutism
3) signs
a) primitive reflexes (frontal release signs)
b) incontinence
c) akinesia, rigidity & tremor
d) low & labile blood pressure
4) neuropsychiatric testing
a) impairment on frontal lobe tests
b) absence of:
1] severe amnesia
2] aphasia
3] perceptuospatial disorder
5) normal conventional EEG despite dementia
6) MRI or PET show predominant frontal lobe &/or anterior temporal lobe abnormality
7) onset before age 65
8) positive family history in a 1st degree relative
9) associated motor neuron disease (minority of patients)
a) bulbar palsy
b) muscle atrophy
c) fasciculations
Notes:
- performance of MMSE may be near normal [3]
Related
frontotemporal dementia; frontotemporal lobar degeneration; frontotemporal neurocognitive disorder (FTD, FTLD)
General
criteria
References
- Cummings JL, The Neuropsychiatry of Alzheimer's Disease
and Related Dementias, Martin Dunitz, 2003
- Piguet O et al.
Sensitivity of current criteria for the diagnosis of
behavioral variant frontotemporal dementia.
Neurology 2009 Feb 24; 72:732.
PMID: 19237702
- Medical Knowledge Self Assessment Program (MKSAP) 17,
American College of Physicians, Philadelphia 2015