American Morning

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March 12th, 2009
06:30 AM ET

Can you explain frontal lobe dementia?

CNN Chief Medical Correspondent Dr. Sanjay Gupta reaches into his mailbag and answers your questions.

Question

A lifelong friend of mine, a “young” 58-year-old, has just been diagnosed with frontal lobe dementia. She was told she’s had it for 20 years, but there have been no noticeable symptoms until the last two years. Can you please shed some light on this disease?

Answer

Thank you, Kathy, for sharing you friend’s story and for the question. While there are many potential causes of dementia, Alzheimer’s is something that often springs to mind. It is often thought of as an older person’s disease, but it can occur in people that are relatively young, like your friend was. Having never seen your friend or examined her, let me instead talk a little about Alzheimer’s. It is a tough thing to understand because we don’t quite know what causes it, or how to cure it.

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Filed under: Dr. Gupta's Mailbag • Health
soundoff (8 Responses)
  1. V Johnson

    My mother has a form of frontal-temporal-lobe dementia. She was in her early-to-mid 60's by the time she finally had anything close to a diagnosis – an MRI revealed "cortical atrophy" which itself isn't a diagnosis, but it's clinical evidence of something wrong. In retrospect, my mother had been exhibiting symptoms of FTD for nearly a decade before the diagnosis. What is frustrating is that my sister and suspected something was not quite right, but just as illustrated by Dr. Gupta's reponse to the initial question, even healthcare providers automatically reach for the Alzheimer's framework when presented with an older adult having cognitive problems. Simple memory tests in the dr's office were useless – FTD does not necessarily affect memory until the disease has progressed significantly. (Please refer to http://www.ftd-picks.org for references beyond my anecdotal account.) But my mother's higher-order cognitive abilities were declining. She was gradually losing her ability to empathize, reason abstractly, or manage complex tasks. What is also frustrating is that so much of her behavior seemed arguably normal – for her. What had been quaint personality quirks were becoming problematic (ie: wanting to talk to EVERYONE she saw in public), but they were just amplified instances of familiar traits.

    My mother is slowing down. She needs help sitting down and getting back up again from the couch. She takes lots of naps. She's easily startled and her emotions seem to fluctuate rapidly – from apathetic to very happy to distressed to apathetic again.

    But to end what could be an endless comment here, I'd like to add that ironically enough I get along better with my mother NOW than I ever did (or least since being weaned!). She's funny, she's silly, she's very very affectionate (lots of hugs, kisses, saying I love you's) and is generally happy and thoroughly enjoying life. All is forgiven – or at least forgotten, the past is gone, the future is irrelevant, we simply share her "perpetual present."

    April 28, 2009 at 9:19 pm |
  2. Ken, a neuropsychologist

    Frontal lobe dementia, which is a subtype of the broader "frontotermporal" dementias, is especially heartbreaking given its early age at onset and prominent personality changes. Dr. Gupta apparently does not know much about this condition– he ignores the question and instead discusses Alzheimer's disease, which is a vastly different disorder. He may be forgiven in that a neurosurgeon usually does not see dementia patients, but he should have acknowledged that up front. Accurate information on frontotemporal dementia, which is the second most common dementia after Alzheimer's, may be found at: the consumer website: http://www.ftd-picks.org or at many university and government sponsored sites by typing "frontotemporal dementia" in a search engine.

    April 17, 2009 at 2:22 pm |
  3. Hilda

    Dear Lisa,

    I also had problems with herpes and after suffering for many months I saw a specialist and he recommended the Aminio Acid L-Lysine, it prevents the virus from coming out.

    If you still get the tingling in the lips you can put an ointment on it as soon as you feel it coming on. The ointment prevents it from spreading and kills the virus, hence no blister. It has been a life savior for me. I get it in Germany and the name is Zovirax.

    I believe you can get in North America with a perscription.
    Do not eat seeds, chocolate, corn, and peanuts. They belong to a certain arganine family and act like fertilizer for the herpes virus.
    Good Luck.

    April 17, 2009 at 1:07 am |
  4. Smartenough2knowwhenidon'tknow

    It appears that you are not psychic, have not seen this patient and do not know what this person's "frontal lobe dementia" actually is. Why don't you just say so, doc? Thank you.
    Sign me, Annoyed w/those who will not admit when they don't know something but must inflict their agenda upon the public.

    April 9, 2009 at 6:07 pm |
  5. rivirivi

    Dear Dr. Gupta: If we know the disease is caused by plaques, why can't we go into the brain and clean it up? Maybe because that sounds too easy it is not tried? what about cleaning the plaques off with mini-water-pressured hoses? I know that sometimes this method is used to clean debris out of the brain when surgery is imminent and the patient has had a auto accident. What are these plaques made of? are they cholesterol? are they like kidney stones?

    April 9, 2009 at 1:03 pm |
  6. Mary

    Congradulations on the new baby.. Too sweet. Little girls with a great dad and momma.
    Disappointed, however that you did not take the position for high office of Surgeon General. I can understand, but, we Americans needed someone with your wisdom and good judgement to change things here in America due our health stature. Sometimes, we are called to hardship and challenge rather than pursuing dreams, of even what you wished to perform surgeries, and closeness of your family. Called the "Road Less Traveled" to do what is needed on a grander scale.
    You, Dr. Gupta are a gift not only to your family, but to mankind, not to be taken lightly, but upon this gift comes responsiblity. There is no one that could do a better job, or has the esteem of people listening to you.

    March 18, 2009 at 1:17 pm |
  7. Lisa Sai

    Dr. Gupta,
    In light of the extremely stressful world that we live in with job loss, the economy, and all the other day to day stresses, have you seen any increases in patients suffering from increased herpes outbreaks? I have had this disease for many years and in the past , very rarely would I ever have an outbreak. However, since Sept. of last year I have had consecutive monthly outbreaks. I have been taking acyclovir 800 mg four times daily for seven days. This dose does work, but the second that I get stressed or worry , I have another outbreak! The outbreaks have become a major source of stress themselves! By the way I have been under a great deal of stress. My doctor has written me a prescription for Valtrex and at the end of this outbreak I am going to switch to Valtrex. I have been to the doctor to verify that the outbreaks are not cancerous. Is the excessive increase in outbreaks normal? Any suggestions besides the obvious of trying to eliminate stress? If you answer this on the air, please don't publish my name.

    Lisa

    March 17, 2009 at 1:53 pm |
  8. John Ortiz

    How do physician incomes and the incentives inherent in our healthcare system compare to the other industrialized countries we are always compared to? How do the differneces contribute to the overall cost of our system?

    March 17, 2009 at 8:53 am |