Frontal presentation of a cerebellar infarct – A memory clinic case study

Abstract

Aim:The aim of this study was to describe the case and assessment of a woman with a right cerebellar infarct whose presentation mimicked that of behavioural variant frontotemporal dementia (bv-FTD).Case report:A 65-year-old woman (J.C) was referred to the service following a marked personality change which occurred over the last 18 months. Her family described symptoms of disinhibition, impulsivity, emotional lability and reduced empathy. In the neuropsychological assessment, the following assessment tools were used: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Hayling and Brixton tests, the the Delis–Kaplan Executive Function System (D-KEFS), Ekman’s 60 faces (FEEST) and the Faux Pas test.Results:Whilst some evidence of executive dysfunction was identified, the psychometric and neuroimaging data was inconsistent with a typical profile seen in bv-FTD.Conclusion:Insufficient evidence was provided to support a diagnosis of bv-FTD. The changes were instead hypothesised to be due to the dysregulation of the cortico-cerebellar/cerebellar-limbic loops produced by J.C’s cerebellar infarct. This case study is a helpful illustration of how psychometric assessment can aid accurate diagnosis in atypical presentations.