A 54-year-old male patient was referred to the emergency department for a rapid progression of lethargic state and apathetic behavior. Assessment in the following days revealed apathic behavior and reduced verbal fluency and severe obstructive sleep apnea syndrome. In the suspect of frontotemporal dementia and to rule out possible neoplastic conditions, the patient was referred to a whole-body and brain [18F]FDG PET/MR. Brain [18F]FDG PET/MR revealed a clear hypometabolism of the frontal cortex bilaterally consistent with a possible behavioral frontotemporal dementia (bvFTD). However, MR revealed a bilateral, anterior thalamic infarcts that could explain the frontal cortical hypometabolism due to subcortical deafferentation. A diagnosis of bilateral strategic infarcts and resulting disconnection of the frontal cortex was established.
Case 9: Frontotemporal Dementia, Behavioral Variant, Mimicker
Cecchin D.;Cagnin A.;
2025
Abstract
A 54-year-old male patient was referred to the emergency department for a rapid progression of lethargic state and apathetic behavior. Assessment in the following days revealed apathic behavior and reduced verbal fluency and severe obstructive sleep apnea syndrome. In the suspect of frontotemporal dementia and to rule out possible neoplastic conditions, the patient was referred to a whole-body and brain [18F]FDG PET/MR. Brain [18F]FDG PET/MR revealed a clear hypometabolism of the frontal cortex bilaterally consistent with a possible behavioral frontotemporal dementia (bvFTD). However, MR revealed a bilateral, anterior thalamic infarcts that could explain the frontal cortical hypometabolism due to subcortical deafferentation. A diagnosis of bilateral strategic infarcts and resulting disconnection of the frontal cortex was established.
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