The case of a 48 year-old woman with bizarre and complex delusions.
BACKGROUND
A 48 year-old woman presented with an 18 month history of bizarre and complex delusions on a background of social, behavioral and cognitive decline over several years. Her psychosis progressed despite receiving high doses of antipsychotics. The patient's father also had a psychotic episode in his 40s. He subsequently developed motor neuron disease, which caused his death at 68 years of age.


METHODS
Physical examination, neuropsychological testing, nerve conduction studies, brain MRI and transcranial magnetic stimulation.


METHODS
On the basis of the patient's age at onset of the delusions, imaging findings and family history, a diagnosis of frontotemporal dementia (FTD) was favored over a primary psychotic disorder. The ubiquitin-positive and TAR DNA binding protein 43-positive inclusions that were found at autopsy confirmed the diagnosis of FTD.


RESULTS
The patient was treated with various antipsychotics at high doses; however, her delusions continued to progress. No disease-specific treatments for FTD currently exist.
Loy
Clement T
CT
Prince of Wales Medical Research Institute, Barker Street, Randwick, Sydney, NSW 2031, Australia.
Kril
Jillian J
JJ
Trollor
Julian N
JN
Kiernan
Matthew C
MC
Kwok
John B J
JB
Vucic
Steve
S
Halliday
Glenda M
GM
Hodges
John R
JR
D001921:Brain / Q000378:metabolism / Q000473:pathology; D003072:Cognition Disorders / Q000209:etiology; D004268:DNA-Binding Proteins / Q000235:genetics / Q000378:metabolism; D003702:Delusions / Q000209:etiology* / Q000473:pathology / Q000523:psychology; D005260:Female; D057180:Frontotemporal Dementia / Q000150:complications* / Q000175:diagnosis / Q000235:genetics; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D009483:Neuropsychological Tests; D010808:Physical Examination / Q000379:methods
D004268:DNA-Binding Proteins