A 79-year-old man presented with a 6-year history of worsening gait and balance. He initially complained of heaviness in his legs followed by forgetfulness and a tendency to stumble and fall, initially forward, but he later started falling backward as well. He also manifested word-finding difficulties and trouble with visual navigation. Four years after symptom onset, he developed paranoid ideation and anxiety during a futile trial of levodopa to address the presumptive diagnosis of Parkinson disease. Within months, he became more belligerent, disinhibited, irritable, and uncharacteristically pejorative. He frequently cried and endorsed depression. Word-finding difficulties were compounded by semantic paraphasias (“garage” instead of “cabinet”). He had difficulty locating the food on his plate when eating, particularly if it was located on the left side of the plate. He became wheelchair dependent. His mother had developed dementia in her late seventies. On exam he was alert, but his verbal output was decreased, with hesitations, blocks, semantic and phonemic paraphasias, and palilalia. He exhibited hypomimia, bradykinesia, and rigidity, but no tremor (Video 16.1). A diagnosis of behavioral variant frontotemporal dementia (bvFTD) was made.