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Yıl:2009; Cilt: 1; Sayı: 3>> Özet
Geriatri ve Geriatrik Nöropsikiyatri Dergisi; 2009;1(3):38-44
Bir Olgu: Frontotemporal Demans ve Duygudurum Bozuklukları
Z Gökmen, Ö Metin, B Cinemre, Ç Özkan
Akdeniz Üniversitesi Tıp Fakültesi
Frontotemporal demans (FTD), anterior temporal ve/veya frontal lobların primer nörodejenerasyonundan kaynaklanır ve biliş, dil, kişilik ve sosyal işlevsellikte belirgin değişiklikler oluşturur. Hastalığın klinik bulguları oldukça heterojendir. Esas olarak kişilik değişikliği ve yönetici işlev bozukluğu ile karakterli frontal tip (fv-FTD) veya davranışsal tip (bv-FTD) ve ilerleyici lisan bozukluğu ile karakterli temporal tip (tv-FTD) olmak üzere başlıca iki klinik tipten bahsedilebilir.

Fv-FTD'ta sinsi başlangıçlı kişilik değişiklikleri ve davranışsal anormallikler başlangıçta en baskın klinik özel­­liklerdir. Bu klinik görünümler temel olarak psiki­yatrik bozukluklarda da sıklıkla bulunmaktadır ve bazı FTD olgularının depresyon, şizofreni, bipolar bozukluk, mani, obsesif kompulsif bozukluk gibi tanılar alabileceği belirtilmektedir. Bu yazıda önce unipolar depresyon daha sonra manik epizod nedeniyle bipolar bozukluk tanısı ile takip edilen ve FTD tanısı alan bir hasta ile FTD ve duygudurum bozuklukları ilişkisi tartışıldı.

FTD'taki duygulanım ve duygudurum bozulmaları birçok yönüyle tanımlanmıştır. Bunlar; depresyon, apati, duygudurum oynaklığı, anksiyete, irritabilite ve öforidir. Bu belirtiler duygudurum bozuklukları ve FTD'ta görülen ortak belirtilerdir. Literatür de FTD bipolar bozukluk birlikteliği ile ilgili çok sayıda vaka bildirilmiştir ve sayıları gittikçe artmaktadır. Bu nedenle duygudurum bozukluğu düşünülen hastalarda FTD ayırıcı tanıda mutlaka akılda tutulmalıdır.
A case: Frontotemporal Dementia and Mood Disorders
Frontotemporal dementia (FTD) is defined as primary neurodegeneration of the anterior temporal and/ or frontal lobes resulting in a variety of associated conditions marked by changes in cognition, [language], personality and social functioning. The clinical findings of this disease are heterogeneous. There are mainly two clinical presentations: 1. Frontal variant or behavioral variant characterized by progressive personality change and dysexecutive function, 2. temporal variant characterized by progressive [language] disorder. In the beginning of the Fv-FTD, insidious personality modifications and behavioral anomalies are the dominant clinical symptoms. Also basically, this clinical symptoms often occur in the psychiatric disorders and some frontotempotal dementia cases can be defined such as depression, schizophrenia, bipolar disorder, mania, obsessive -compulsive disorder. In this paper, the relationship between mood disorders and FTD is discussed in the context of a case report presenting initially with unipolar depression who is later followed with the diagnosis of mood disorder, manic episode and finally has been diagnosed as FTD. Affective and mood disorders in FTD are defined by a variety of clinical manifestations. These are depression, apathy, mood swings, anxiety, irritability and euphoria. These symptoms are common symptoms of FTD and mood disorders. In the literature, there are numerous case reports which are related with frontotemporal dementia bipolar disorder and the number of the cases has been increasing. Therefore in the differential diagnosis, FTD has to be considered as a serious option for the patients who present with mood disorder symptoms.

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