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1st February 2024

Clinical features

  1. General symptoms of behavioural variant FTD:
    • Behavioural changes:
      • Making inappropriate comments
      • Overfamiliar, socially disinhibited
      • Impulse-losing inhibitions
      • Commenting on others’ appearances, being insensitive and rude, staring
      • Sexual gestures in public
      • Aggressive verbally, physically
    • Changes in food and drinking behaviours: Overeating, craving sweet food, poor table manners, drinking excessively, and not knowing when to stop eating or drinking.
    • Poor organising skills, planning and decision-making.
    • Poor insight- lack of awareness of changes in themselves (Anosognosia)
    • Poor empathy- fail to understand others and less considerate of their feelings (alexithymia)
    • Poor motivation to do things, anhedonia
    • Reduced concentration and ability to focus (gets distracted easily)
    • Repetitive and or obsessive behaviours- Repeating phrases, gestures, hoarding
  2. Semantic variant PPA:
    • Although this mainly involves language, other FTD symptoms might present too
      • They lose their vocabulary over the days: Initially complicated words and then later simple ones.
      • They may forget the functions of familiar objects: The use of fridge, microwave
      • Loss of skill to use simple objects in day-to-day life: use of comb, toothbrush
  3. Non-fluent variant PPA:
    • Although this mainly involves language, other FTD symptoms might be present too. As the name suggests, the problem is in speaking fluently
      • Poor grammatical sentences (agrammatism)
      • Short telegraphic speech, sound errors
      • Saying the opposite of what they want to
      • They might understand a particular word but not when in a sentence
  4. Late stages of FTD:
    • Cognitive impairment
    • Psychotic symptoms
    • BPSD
    • Poor recognition of people
  5. Progressive Supranuclear palsy:
    • Postural instability
    • Vertical Supranuclear ophthalmoparesis
    • Very similar to multiple system atrophy, Parkinson’s
    • Axial rigidity
  6. Cortico-basal degeneration:
    • Asymmetric ideomotor apraxia
    • Alien limb phenomenon
    • Visual, sensory hemineglect
    • Myoclonus
    • Non-fluent aphasia
    • Extrapyramidal dysfunction
    • Repeated falls, balance problems
    • Syncope
    • Transient loss of consciousness
    • Neuroleptic sensitivity
    • Rapid eye movement sleep disorder
    • Systematised Delusions
    • Restless Leg Syndrome
    • Autonomic dysfunction- constipation, orthostatic hypotension, urinary incontinence
    • Speech and swallowing problems
  7. Behavioural problems:
    • Anger, agitation
    • Depression, Anxiety
    • Apathy
    • Excess daytime sleeping
    • Problems following instructions, handling money

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