Citation

Sommerlad A, Lee J, Warren J, Price G. BMJ Case Rep. 2014; 2014(ePub): ePub.

Affiliation

Department of Neuropsychiatry, University College London Hospitals, London, UK.

Copyright

(Copyright © 2014, BMJ Publishing Group)

DOI

10.1136/bcr-2013-203458

PMID

24928930

Abstract

A man presenting in his 50s, following conviction for a non-violent crime, to forensic psychiatric services, and then to a neuropsychiatry service with an unusual presentation of psychosis: second person auditory hallucinations, grandiose delusions and somatic delusions. Detailed collateral and family history revealed a background of progressive cognitive deficit and a family history of motor neuron disease. MRI of the brain revealed asymmetrical parieto-occipital volume loss and genetic testing demonstrated a pathogenic expansion of the chromosome 9 open reading frame 72 (C9ORF72) gene consistent with familial frontotemporal dementia caused by a hexanucleotide repeat expansion at C9ORF72, a recently discovered cause of familial frontotemporal dementia/motor neuron disease. This form of frontotemporal dementia should be considered as an important potential differential diagnosis for patients presenting with psychotic symptoms in later life, in whom a detailed family history and thorough cognitive assessment is essential.

Language: en