Catatonia in Patients with Frontotemporal Dementia

Abstract

Introduction Catatonia is a neuropsychiatric syndrome described in a variety of medical and psychiatric conditions. Its association with frontotemporal dementia (FTD) has been sparsely described. Objetives We reported two patients with FTD that present a catatonic state. Aim Case reports Method Literature review through Pubmed and report of a clinical cases. Results Case 1: Frontotemporal dementia, behavioral variant. 65 year old female who was hospitalized after losing weight due to his active refusal to eat and subsequently was undergone a gastrostomy. Once stabilized physically was derived to psychogeriatric ward where the patient was stuporous, mute, with mannerisms and rigidity. Continued with refusal to take food. On examination she had staring, posturing, echophenomena, automatic obedience, Gegenhalten, ambitendency and perseveration. It featured 12 of 23 symptoms of Bush and Francis Catatonia Rating Scale (BFCRS), scoring 32. She improved completely her catatonic state within one week with lorazepam 2.5 mg /day and zolpidem 10mg/day. Perseverative behavior and mannerisms was maintained. Case 2: Frontotemporal dementia, primary progressive aphasia 67 years old male who was admitted to psychogeriatric ward because had aggressivity and negativism. On examination immobility, mutism, staring, echolalia, rigidity, negativism, withdrawal, perseveration, Gegenhalten, impulsiveness and combativeness were observed. It featured 11 of 23 symptoms of BFCRS, scoring 22. He was treated with lorazepam 10mg/day and valproic acid 900 mg/day. Catatonic symptoms disappeared a month later. Negativism and impulsiveness persisted slightly. Conclusions The catatonic syndrome may occur in patients with FTD. In both conditions symptoms overlap. The response to GABAergic drugs was optimal.