Age of onset |
72 |
49 |
64 |
Duration (months) |
18 |
25 |
29 |
Clinical appearance (syndrome) |
MND/PSP/FTLD |
FTLD |
FTLD/PSP |
|
Central motoneuron dysfunction |
Hyperreflexia |
Generalized spasticity |
Right-sided spasticity |
Periferal motoneuron dysfunction |
Yes, EMG proven |
Interosseal amyotrophy |
No |
Dysarthria/dysphagia |
Yes, prominent |
Yes, later |
Yes-early/prominent |
Early falls |
Yes |
Yes |
Yes |
Eyelid opening apraxia |
Early |
Late |
Present |
Oculomotoricity, conjugate ocular pursuit movements |
Abnormal/Voluntar movements reduced both horisontally and vertically |
Initially normal, reduced mainly vertically, but after one year |
Reduced mainly vertically |
Saccades |
Slow, hypometric |
Slow, hypometric |
Slow, hypometric |
Bradykinesia |
Axial predominance |
Axial and limbs |
Axial predominance |
Rigidity |
Axial predominance |
Axial and limbs |
Axial predominance |
Tremor |
No |
No |
No |
Dystonia |
No |
Facial movements, neck anteflexion and lateroflexion |
Late - retrocollis |
Response to L-dopa |
Poor |
Poor |
Non |
Executive dysfunction |
Prominent |
Prominent |
Prominent |
Insight |
Lacking |
Present at the beginning |
Lacking |
Frontal release signs |
Grasping/spastic laughter/disinhibited behavior |
Behavioral changes, dysexecutive syndrome |
Behavioral changes |
Memory problems |
Minimal |
Minimal, effect of cueing |
Impaired |
Visuospatial dysfunction |
Impaired |
Impaired |
Impaired |
Gait apraxia |
Early feature |
Present early |
Early |
Autonomic function |
N/A |
Not present |
Not present |
|
Case 1 |
Case 2 |
Case 3 |
|
MRI |
Frontotemporal atrophy with left predominance |
Generalized atrophy with mild predominance periventriculary and frontal |
Frontotemporal and brainstem atrophy |
Cerebrospinal fluid |
Normal |
Not done |
Normal |
EMG |
Probable ALS according to El Escorial criteria, normal conduction |
Not done |
Normal conduction, no denervation |
|
Pathological diagnosis |
FTLD-TDP/MND |
FTLD-TDP/MND |
FTLD-TDP/MND |