Identification and Description of Signs, Symptoms, and Potential Syndromes
The patient in the present case is F.G., a 68-year-old woman. She displays many symptoms that have been progressing in the last two years. The most acute problems are difficulty speaking and paralysis of the lower face on the right side. F.G. has been having headaches in the morning and nausea for the last two years.
In the previous 6-8 months, the patient’s condition progressed, and she showed changes in behavior – aggressiveness, impulsiveness, and lack of concern. Finally, F.G. has memory problems while speaking or repeating words and phrases, although her visual memory seems intact. Diagnostic tests reveal increased intracranial pressure, which is also a potential symptom.
Assessment of Impacted Cognitive Domains and Brain Damage Localization
Impacted Cognitive Domains
The affected cognitive domains are language, memory, and executive function. First, free recall impacts the learning and memory domain. Free recall refers to reproducing words from short-term memory and repeating them correctly (Jahn, 2022). During language tests, the patient could not say a list of words or a phrase said to her, which showed that her short-term memory was not functioning correctly. Moreover, she added words not on the list and repeated them, implying a significant impairment in her memory processes. The patient appears not to have vision or interpretation problems, as she could draw figures as instructed (PSYC 3250, n.d.b).
Second, F.G. also has trouble speaking in general, which signifies word-finding difficulty. The patient completes short sentences and needs more time to formulate a statement. Finally, executive function includes inhibition and working memory (PSYC 3250, n.d.a). This domain is responsible for the patient’s impulsive behavior, aggressive speech, and mood swings.
Brain Damage Localization
The frontal and temporal lobes are possible locations of brain damage. Executive function issues are linked to problems in the lateral prefrontal cortex (PSYC 3250, n.d.a). For instance, the dorsal prefrontal cortex is responsible for working memory. The prefrontal region also controls one’s impulse control and social cognition. Damage to this part of the brain could explain the patient’s inability to control emotions and recognize emotions in other people, as she currently feels no remorse or concern about her behavior (Ducharme et al., 2020). The lateral prefrontal area may also influence verbal expression, with which F.G. struggles.
The anterior cingulate cortex is a part of the frontal part of the brain. This area regulates emotions and cognitive functions (PSYC 3250, n.d.a). The patient’s lack of empathy may be connected to trauma in the anterior cingulate cortex, as emotional information is processed in this region and the amygdala (PSYC 3250, n.d.a).
Furthermore, dorsal anterior cingulate damage may result in poor decision-making because this part of the brain helps determine the risks of actions. Similarly, the temporal lobe also controls one’s memory storage, language expression, and emotion processing. The most significant part is the amygdala, which manages emotional responses (PSYC 3250, n.d.a). Otherwise, the frontal lobe is the brain region where damage is possible in the patient.
Proposed Diagnoses: Evaluating Potential Conditions and Identifying the Most Likely Diagnosis
The variety of symptoms suggests many possible diagnoses, and more tests are necessary before making the final decision. It is unclear which tests were performed during the initial visit, so brain imaging tests such as computerized tomography (CT) scan or magnetic resonance imaging (MRI) can be suggested. An MRI helps view the activity and degeneration of the brain, which could help eliminate or confirm dementia (Jahn, 2022). A CT scan can further support the diagnosis and find whether the patient has tumors, injuries, or signs of stroke (Jahn, 2022). Additional tests, such as positron emission tomography (PET), may be necessary if the diagnostic process does not confirm a diagnosis.
Alzheimer’s Disease
The first potential diagnosis for the patient is Alzheimer’s disease (AD) – a degenerative condition that progresses throughout one’s life. AD symptoms include short-term memory loss, cognitive difficulties, shrinking vocabulary, mood changes, aggressiveness, or apathy (Jahn, 2022). This condition presents in different ways, and the patient’s progression of symptoms is similar to the changes through which patients with AD go. However, such symptoms as morning headaches, nausea, and mild paralysis are not characteristic of this disease, which lowers the possibility of this diagnosis.
Frontotemporal Dementia
The second possible diagnosis is frontotemporal dementia (FTD) – a progressive disorder that affects one’s frontal and temporal lobes. The signs of FTD are similar to Alzheimer’s but are distinguished by impulsiveness and poor decision-making, language-specific issues, and lack of inhibition in speech and behavior (Ducharme et al., 2020). This condition is more consistent with the presentation because the patient demonstrates difficulties with speaking, which are common when degeneration occurs in the frontal lobe.
References
Ducharme, S., Dols, A., Laforce, R., Devenney, E., Kumfor, F., Van Den Stock, J., et al. (2020). Recommendations to distinguish behavioural variant frontotemporal dementia from psychiatric disorders. Brain, 143(6), 1632-1650. Web.
Jahn, H. (2022). Memory loss in Alzheimer’s disease. Dialogues in Clinical Neuroscience, 15(4), 445-454. Web.
PSYC 3250. (n.d.a). Attention & awareness (neglect syndromes).
PSYC 3250. (n.d.b). Visual perception (vision deficits).