Frontotemporal dementia (FTD) is now increasingly being recognized as one of the causes of young onset dementia (YOD). The presentation of FTD can be subtle with a broad range of symptoms. This frequently causes misdiagnosis and a delay in initiating the correct treatment. While subtle personality changes, disinhibition and problems in executive functioning are frequently encountered in FTD, frank psychotic symptoms resembling schizophrenia are unusual. This is a case of a 38 year old Chinese female that highlights how obsessive compulsive symptoms which progressed to florid psychosis and disorganized speech and behavior can be a presenting picture in FTD. For seven years, this patient was treated as a case of schizophrenia and was thought to have poor response to electroconvulsive therapy (ECT) as well as antipsychotic medication. Her blood work and electroencephalogram (EEG) were normal. Magnetic resonance imaging (MRI) showed progressive cerebral atrophy. This case report suggests that psychosis should be investigated in detail especially when the clinical presentation is not typical of a functional disorder and more so when the patient is not responsive to conventional treatment. This report also highlights the importance of eliciting symptoms suggestive of an "organic" etiology, such as incontinence and disorientation. In addition, the usefulness of repeated imaging to show the rapidly progressive course of FTD has been illustrated. Other possible differential diagnoses of this patient are also discussed.
Digital elevation model (DEM) generation from stereo images is an effective and economical method in topography mapping. This paper used the stereo pair methodology to generate the digital elevation model (DEM) from PRISM (Panchromatic Remote-Sensing Instrument Satellite) sensor which is onboard of ALOS (Advanced Land Observing Satellite). The pair of forward-backward is used as stereoscopic imagery in this study. Ten ground control points (GCPs) are collected with residual error 0.49 pixels to generate an absolute DEM. This generated DEM with 2.5 m spatial resolution is then matched with the 90 m spatial resolution of
SRTM (Space Shuttle Radar Topography Mission) DEM to compare the result. Although SRTM-DEM has a much coarser resolution, the positional accuracy of the matching is found. The difference of the height from the mean sea level (MSL) between the SRTM-DEM and the PRISM-DEM is analyzed and the correlation between the two DEMs is R²=0.8083. The accuracy of the DEM generated is given by the RMSE value of 0.8991 meter.
Objective: This case report highlights the challenges in managing Frontal Lobe Syndrome (FLS) in a patient with end-stage renal disease. Methods: This is a case description of a 58 year-old gentleman who presented with behavioural changes: irritability, mood lability, aggression, psychosis, and overfamiliarity. His presenting symptoms were in keeping with (FLS) with positive findings on Computed Tomography (CT) scan of the brain and also neuropsychological assessments. Difficulties arose in attempts to control his aggression without further compromising his renal function. Results: The usage of the commonly used antipsychotics in controlling aggression was restricted in view of the patient’s renal impairment. Augmentation with low dose memantine proved to be beneficial in this case, without causing further deterioration in renal function. Conclusion: The use of memantine to augment the effect of risperidone was observed to be safe and successful in managing the behavioural changes associated with FLS in adults with end-stage renal disease. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 93-96.