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Case 26 - University educated man with childish behavior

Published online by Cambridge University Press:  16 May 2011

Serge Gauthier
Affiliation:
McGill University, Montréal
Pedro Rosa-Neto
Affiliation:
McGill University, Montréal
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Summary

This chapter talks about a 39-year-old man, a human resource executive, who was seen at the outpatient clinic of the Behavioral and Cognitive Neurology Unit of the Hospital das Clı´nicas, a public university hospital in Sao Paulo, Brazil. Physical examination showed a well-nourished man, with a blood pressure of 130/80 mmHg, and neurologic examination revealed only dysarthria, with normal and reactive pupils and normal reflexes. His insight about his problems seemed to be normal. The initial diagnostic impression was a Frontotemporal Dementia (FTD), but the final diagnosis was of paretic dementia, a neuropsychiatric condition caused by neurosyphilis. He was treated with intravenous aqueous crystalline penicillin G, 4 million units every 4 hours for 21 days, and with fluoxetine. FTD or behavioral subtype of fronto-temporal lobar degeneration was the initial diagnosis in this case because the clinical picture was dominated and confirmed the presence of frontal or fronto-temporal involvement.
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Case Studies in Dementia
Common and Uncommon Presentations
, pp. 193 - 200
Publisher: Cambridge University Press
Print publication year: 2011

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