Okada Akira, Ohyama Kakusho, Ueda Tetsuya
Department of Neuropsychiatry, Faculty of Medicine, Nara Hospital Kindai University, Ikoma, Japan.
Center for Health Affairs, Kindai University, Higashiosaka, Osaka, Japan.
BMJ Case Rep. 2018 Jun 29;2018:bcr-2018-224431. doi: 10.1136/bcr-2018-224431.
The right temporal lobe variant of frontotemporal dementia (FTD) is an uncommon progressive neurodegenerative disorder. We present the case of a 77-year-old right-handed man who presented with altered behaviour and problems with interpersonal relationships. He had no decline in cognitive function but brain perfusion single-photon emission CT demonstrated distinct hypoperfusion in the right temporal pole. At 2-year follow-up, he could not recognise his wife's relatives; and at 3-year follow-up, he had semantic aphasia. Decreased brain perfusion extended from the right temporal lobe into the contralateral temporal and both frontal lobes. These findings suggest that the right temporal lobe variant of FTD should be considered in elderly patients with altered behaviour and problems with interpersonal relationships, even if dementia is not suspected. The right anterior temporal lobe may play a key role in the onset of the early symptoms of this disease.
额颞叶痴呆（FTD）的右侧颞叶变异型是一种罕见的进行性神经退行性疾病。我们报告一例77岁右利手男性病例，该患者出现行为改变及人际关系问题。其认知功能无下降，但脑灌注单光子发射计算机断层扫描显示右侧颞极有明显灌注不足。在2年随访时，他无法认出妻子的亲属；在3年随访时，他出现了语义性失语。脑灌注减少从右侧颞叶扩展至对侧颞叶及双侧额叶。这些发现表明，即使未怀疑患有痴呆，对于有行为改变及人际关系问题的老年患者，也应考虑FTD的右侧颞叶变异型。右侧颞前叶可能在该疾病早期症状的发作中起关键作用。
