A 55-year-old male presented with complaints of apathy, disinhibition, and compulsive behaviour, loss of empathy, overeating, easy forgetfulness and amnesia. There is also a family history of dementia. MRI of the brain was ordered. A brain biopsy was also taken and HPE examination was done. What is the most likely Diagnosis?
The history of early personality changes followed by memory loss along with Pick cell (ballooned cell with dissolution of chromatin suggestive of pick body) is suggestive of Picks disease. MRI shows anterior cingulate and frontoinsular atrophy, spreading to orbital and dorsolateral prefrontal coex. OPTION A- Alzheimer's disease would have early memory loss, later symptoms of personality changes. Option B - Vascular dementia would have focal neurological deficit due to stroke and a step ladder progression. Option D - Lewy body dementia would show fluctuating amnesia with visual hallucination with spontaneous Parkinsonism.
Alzheimer's disease
Vascular dementia
Frontotemporal dementia
Lewy body dementia
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