A frontotemporal dementia-like case after high-altitude climbing

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Tunalı C. H., Ünal S., Kamışlı S.

Egyptian Journal of Neurology, Psychiatry and Neurosurgery, vol.59, no.1, 2023 (ESCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: 59 Issue: 1
  • Publication Date: 2023
  • Doi Number: 10.1186/s41983-023-00610-0
  • Journal Name: Egyptian Journal of Neurology, Psychiatry and Neurosurgery
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, Arab World Research Source, EMBASE, Directory of Open Access Journals
  • Keywords: High altitude sickness, Possible frontotemporal dementia, Neuropsychiatric sequelae, Donepezil, Case report, BEHAVIORAL VARIANT, CRITERIA
  • Bursa Uludag University Affiliated: No


© 2023, The Author(s).Background: We report a case who developed long-term neuropsychiatric sequelae similar to frontotemporal dementia after suffering a "high altitude sickness" while climbing a high mountain without taking precautions against acute hypoxia. Case presentation: The 57-year-old patient showed symptoms of acute mountain sickness after climbing 3500 m. A few months after descending the mountain, he developed symptoms such as loss of empathy, decreased speech, perseveration, echolalia, and increased interest in sugary foods. The patient's MRI and PET/CT results were consistent with frontotemporal neurodegeneration. After the start of donepezil, persecution delusions developed, and the clinical picture worsened. In the process, he developed visual agnosia and anomic aphasia. Although there was no significant change in personality traits at the beginning, the patient developed apathy, loss of inhibition, lack of empathy, progressive aphasia, and problems perceiving and expressing emotions. A significant loss of function occurred within 4 years. The patient met the criteria for "probable behavioral variant frontotemporal dementia", but was defined as a frontotemporal dementia-like case due to possible relevance to a medical condition affecting the brain. Conclusions: This case suggests that clinicians should be more careful about the chronic consequences of high-altitude diseases and avoid cholinesterase inhibitors such as donepezil, as it can worsen behavioral symptoms of frontotemporal dementia-like symptomatology.