Behavioral Variant Frontotemporal Dementia versus Primary Psychiatric Disorder: A Complex Case of Early Onset Dementia

<h2>Abstract</h2> This case report will review the diagnosis and management of a 31-year-old patient initially misdiagnosed with schizophrenia with catatonic features who was later found to have behavioral variant frontotemporal dementia (bvFTD). His young age of onset initially confounded this diagnosis. However, progressive aphasia, lack of response to psychopharmacology and ECT and ultimately neuroimaging changed the likely diagnosis to bvFTD. Management expectations were altered to address his most disruptive behaviors, primarily constant pacing, aggression with care, disrobing and hyperorality. This care report also summarizes the most recent recommendations from consensus reports, reviews and meta analyses for the diagnostic workup of bvFTD as well as psychopharmacological and behavioral management recommendations for the neuropsychiatric symptoms of bvFTD. The case report highlights a unique case of behavioral variant frontotemporal dementia misdiagnosed as a psychotic disorder. The unusual age of onset was a major confounder in this patient's diagnosis. We also performed a literature review of the most up to date diagnostic and treatment strategies for this disorder.