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Frontotemporal dementia

Degeneratio lobaris frontotemporalis · Frontotemporální demence

What it is

Degeneration of the frontal and temporal lobes, usually starting between 45 and 65, that changes personality, behaviour or language before memory; up to a third is inherited (C9orf72, GRN, MAPT).

Symptoms & signs

  • Loss of tact and empathy
  • disinhibition or apathy
  • compulsive habits, craving sweets
  • losing word meanings or halting speech
  • memory spared early
  • some develop motor neurone disease

🚩 Get help if…

  • call 112 / 911 now Choking on food or drink, or a chest infection with fast breathing
  • see a doctor soon Sudden worsening of confusion or behaviour over days
  • see a doctor soon Risky acts — reckless spending, driving, sexual or unsafe behaviour
  • see a doctor soon Weight loss or stopping eating and drinking

Where it strikes

Medical treatment

  • MRI and FDG-PET; genetic testing when there is a family history
  • no drug slows it
  • SSRIs or trazodone for behaviour mixed evidence
  • Cholinesterase inhibitors — no benefit, may worsen behaviour not confirmed in trials
  • speech therapy
  • carer support and early legal planning

Natural & lifestyle

  • Routine and structure
  • regular exercise
  • carer education and respite

Emerging & experimental

  • Progranulin-raising drugs for GRN carriers
  • antisense therapy for C9orf72
  • gene therapy

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Mediterranean diet — good for the brain in general; untested in FTD anecdotal / traditional
  • Transcranial stimulation — small studies in the language forms early / small studies
  • Ginkgo biloba — did not prevent dementia (GEM trial) not confirmed in trials

ICD codes