Frontal Pick's Disease

Summary The authors reported a case of frontal Pick's disease clinicopathologically. (1) Clinical course: In a 77‐year‐old female patient at the time of death, the disease began with inattentiveness, indifference and forgetfulness at the age of 71. She was euphoric and showed uninhibited manner towards her surroundings. Meaningless hyperactivity was not noted. The disease was progressive and she became demented and filthy. In the terminal stage, she was confined to bed and totally out of contact. “Stehende Redensarten” was not noted throughout her stay in the hospital, but a slight echoing of phrases was noted. (2) Histopathological findings: The brain weighed 980 g. In the frontal lobe, the right convexity and the left FI and bilateral orbital gyri were atrophic. In the temporal lobe, the right hippocampal gyrus was slightly atrophic with a slight fibrillary gliosis in the right T2. The right temporal pole, T2, T3 and T4 showed nerve cell loss and astrocytic proliferation. Fibrillary gliosis was noted in the hippocampal gyrus bilaterally. Pick's cells were found. (3) Histopathological changes in the cerebral cortex were widespread than was indicated grossly, being present to varying extent in non atrophic temporal areas. From the survey of the literature and from our case, it is concluded that in frontal Pick's disease “stehende Redensarten” has been reported to be less frequent than in temporal or temporo‐frontal types.