Kawasaki Memorial Hospital, Kawasaki-city, Japan.
Psychogeriatrics. 2019 Sep;19(5):505-509. doi: 10.1111/psyg.12405. Epub 2019 Feb 6.
We herein report two patients with dementia with Lewy bodies (DLB) presenting characteristic symptoms suggestive of the behavioural variant of frontotemporal dementia (bvFTD). Patient 1 presented behavioural and personality changes from the onset, such as restlessness, compulsive behaviours, and stereotypical speech. A neuroimaging study showed preferential frontal involvement, and this patient fulfilled the diagnostic criteria for bvFTD. However, I-metaiodobenzylguanidine cardiac scintigraphy revealed a markedly lowered uptake, suggesting the diagnosis of possible DLB. Patient 2 fulfilled the criteria for probable DLB, but later presented bvFTD-like symptoms similar to those in patient 1. These patients suggest that DLB can be a candidate for differential diagnosis of bvFTD in the clinical setting.
我们在此报告两例以行为变异型额颞叶痴呆(bvFTD)为特征的路易体痴呆(DLB)患者。患者 1 从发病开始就出现行为和人格改变,如躁动不安、强迫行为和刻板言语。神经影像学研究显示额皮质优先受累,该患者符合 bvFTD 的诊断标准。然而,碘[123I]-间位碘苄胍心脏闪烁扫描显示摄取明显降低,提示可能为 DLB 诊断。患者 2 符合可能的 DLB 标准,但后来出现与患者 1 类似的 bvFTD 样症状。这些患者提示 DLB 可能是临床情况下 bvFTD 的鉴别诊断之一。