Frontotemporal dementia
Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- coarsening of personality, social behavior, and habits
- progressive loss of language fluency or comprehension
- development of memory impairment, disorientation, or apraxias
- progressive self-neglect and abandonment of work, activities, and social contacts
Otros factores de diagnóstico
- early age at onset
- family history of frontotemporal dementia (FTD)
- altered eating habits
- inattentiveness, puerile preoccupations, economy of effort, impulsive responding, and compulsive behaviors
- signs of amyotrophic lateral sclerosis (ALS)
- parkinsonian symptoms
- fasciculations, atrophy, hyperreflexia, and other signs of motor neuron disease
- glabellar, snout, sucking, rooting, or grasp reflex
- loss of bladder and bowel control
Factores de riesgo
- mutations in MAPT gene
- mutations in GRN gene
- mutations in C9orf72 gene
- other mutations
- traumatic brain injury
- post-traumatic stress disorder (PTSD)
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- cognitive testing
- brain MRI
- brain CT
- CBC
- serum CRP
- serum thyroid-stimulating hormone (TSH)
- free thyroxine (T4)
- metabolic panel
- serum BUN
- serum creatinine
- LFTs
- serum vitamin B12 levels
- serum folate levels
- syphilis serology
- HIV testing
- serum enzyme-linked immunosorbent assay
Pruebas diagnósticas que deben considerarse
- brain fluorodeoxyglucose (FDG)-PET/CT
- brain perfusion single-photon emission computed tomography (SPECT)
- brain amyloid PET/CT
- brain biopsy
- genetic testing
- connective tissue panel
- serum erythrocyte sedimentation rate
- electroencephalogram (EEG)
- electromyogram (EMG)
Pruebas emergentes
- fluid biomarkers
Algoritmo de tratamiento
all patients
Colaboradores
Autores
Raghava Kurup Radhakrishnan, DPM(NIMHANS), DNB(Psych), FRCPsych
Consultant Psycho-geriatrician
Waitemata District Health Board
Auckland
New Zealand
Divulgaciones
RKR serves as an advisory board member for the Australian and New Zealand Journal of Psychiatry.
Rommel Dawith, MBChB, FRANZCP, FFPOA
Psychiatrist of Old Age
Waitemata District Health Board
Auckland
New Zealand
Divulgaciones
RD declares that he has no competing interests.
Agradecimientos
Dr Raghava Kurup Radhakrishnan and Dr Rommel Dawith would like to gratefully acknowledge Dr Sachin Jauhari, Dr Lawrence Whalley, and Dr Chiadi Onyike, the previous contributors to this topic, and colleagues Dr Ann Boston (clinical psychologist), Dr Zara Godinovich (clinical psychologist), and Diane Ellis (clinical nurse specialist) for their suggestions.
Divulgaciones
SJ, LW, CO, AB, ZG, and DE declare that they have no competing interests.
Revisores por pares
Daniel Kaufer, MD
Director
Memory Disorders Program
Department of Neurology
University of North Carolina at Chapel Hill
NC
Divulgaciones
DK has received research support, speaking honoraria, and consulting fees from Eisai, Forest Laboratories, Johnson & Johnson, Medivation, Novartis, Ortho-McNeil, and Pfizer.
Bruce L. Miller, MD
Professor of Neurology
University of California
San Francisco
CA
Divulgaciones
BLM declares that he has no competing interests.
Philip Scheltens, MD, PhD
Professor of Neurology
Department of Neurology/Alzheimer Center
VU University Medical Center
Amsterdam
The Netherlands
Divulgaciones
PS declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Rascovsky K, Hodges JR, Knopman D, et al. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain. 2011 Sep;134(Pt 9):2456-77.Texto completo Resumen
American College of Radiology. ACR appropriateness criteria: dementia. 2024 [internet publication].Texto completo
Buoli M, Serati M, Caldiroli A, et al. Pharmacological management of psychiatric symptoms in frontotemporal dementia: a systematic review. J Geriatr Psychiatry Neurol. 2017 May;30(3):162-9. Resumen
Reus VI, Fochtmann LJ, Eyler AE, et al. The American Psychiatric Association practice guideline on the use of antipsychotics to treat agitation or psychosis in patients with dementia. Am J Psychiatry. 2016 May 1;173(5):543-6.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
დიფერენციული დიაგნოზები
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Más Diferencialesგაიდლაინები
- European intersocietal recommendations for the biomarker-based diagnosis of neurocognitive disorders
- ACR appropriateness criteria: dementia
Más გაიდლაინებიპაციენტის ბროშურები
Caring for someone with dementia
Dementia: frontotemporal dementia
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