ECT as a Useful Treatment Strategy for Difficult-totreat FTD: A Case Report and Review of Literature

Abstract

Frontotemporal dementia (FTD) defines a heterogeneous group of clinical syndromes marked by the progressive, focal neurodegeneration of the frontal and anterior temporal lobes. The variety of presentations causes special diagnostic difficulties that can have a major negative influence on patient care and advice for carers regarding the clinical status and prognosis. To differentiate FTD from other psychiatric disorders, a combination of clinical assessment, neurological examinations, and imaging tests such as MRI or PET scans are used. It is important to rule out other potential causes of cognitive impairment, such as vitamin deficiencies, infections, or tumours. A neuropsychological evaluation can also help identify patterns of cognitive deficits typical of FTD.

Here we present a case of a 58-year-old male in whom diagnoses were revised multiple times before finally reaching the diagnosis of Frontotemporal dementia. In the course of his illness, he developed catatonic symptoms and marked agitation which were not improving on antipsychotics and oral/iv Lorazepam. ECT was started and the patient showed improvement in catatonic symptoms, repetitive behaviour, agitation, and sleep disturbance. The patient became calm and manageable although he still required assistance in performing ADL.