| Abstract | INTRODUCTION: Cholinesterase inhibitors are useful in the treatment of behavioural and psychological symptoms in Alzheimer's disease. Their effectiveness in frontotemporal dementia has not been proved, since such a claim has only been backed by the publication of one open-label trial in which the behavioural and psychological symptoms of the patients treated with rivastigmine over a 12-month period improved significantly with respect to those belonging to a group that were given a placebo. We report a case of frontotemporal dementia, Pick's disease, which improved with rivastigmine treatment. CASE REPORT: A 61-year-old male who presented a progressive clinical picture of behavioural disorders and executive-cognitive impairment that had begun two years earlier. Magnetic resonance imaging of the head revealed severe frontotemporal atrophy. Neuropsychological Inventory (NPI). Overall score 36/144 (6/12: anxiety, disinhibition and aberrant motor behaviour, 4/12: agitation, irritability and apathy; 3/12: sleep and eating disorders. After three months' treatment with rivastigmine, the overall score on the NPI was 10/144. This improvement remained stable over the months that followed. The patient died eight months later after developing liver cancer with metastasis. The microscopic study of the brain showed tau-positive neuronal inclusions, gliosis and neuronal loss. The inclusions were well-circumscribed Pick bodies, which were present in the frontal and temporal cortices and in the dentate gyrus of the hippocampus. CONCLUSIONS: This case confirms the idea that treatment with cholinesterase inhibitors can be effective in the behavioural and psychological symptoms of frontotemporal dementia. |
| Authors | T Calatayud-Noguera, A Astudillo-González, J C Alvarez-Carriles, T Temprano-Fernández, M Cortés-Velarde, P Oliva-Nacarino
(Affiliation: Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain. tcalatayudn at gmail.com)
|
| Journal | Revista de neurologia
(Rev Neurol)
2009 Jun 1-15
Vol. 48
Issue 11
Pg. 582-4
ISSN: 1576-6578 [Electronic] Spain |
| Vernacular Title | Rivastigmina en un caso de demencia frontotemporal, enfermedad de Pick verificada por autopsia. |
| PMID | 19472156
(Publication Type: Case Reports, English Abstract, Journal Article)
|
| Chemical References |
- Cholinesterase Inhibitors
- Phenylcarbamates
- rivastigmine
|
| Topics |
- Alzheimer Disease
(drug therapy, physiopathology)
- Autopsy
- Brain
(pathology)
- Cholinesterase Inhibitors
(therapeutic use)
- Fatal Outcome
- Humans
- Male
- Middle Aged
- Phenylcarbamates
(therapeutic use)
- Pick Disease of the Brain
(drug therapy, pathology, physiopathology)
- Treatment Outcome
|
