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Headache is an uncommon symptom in Guillain–Barré syndrome (GBS). We review four clinical settings related to GBS in which headache may be present. We focus on pathophysiological explanations, alerting the clinician to further potential investigations and treatment. Most reports of headache in GBS occur in the context of the posterior reversible encephalopathy syndrome, an increasingly recognized dysautonomia-related GBS complication. Less frequent is headache in the setting of increased intracranial pressure and papilledema (secondary intracranial hypertension), Miller Fisher syndrome, and cerebral venous sinus thrombosis. Rarely, headache can occur secondary to aseptic meningitis from IVIg use.
This chapter presents a case study of a 69-year-old right-handed man who was presented in June 2006 with a 1-year history of progressive word finding difficulties and mild phono-articulatory problems. It provides the general history, family history, examination, initial diagnosis and follow-up data of the patient. In a simple delayed recall test, he was able to remember five out of ten figures, which is considered slightly impaired. Based on the overall clinical, neuropsychological, language, and neuroimaging data, a diagnosis of Progressive Non-Fluent Aphasia (PNFA) was made. Duloxetine was started for the depressive symptoms with good clinical response. Primary progressive aphasia (PPA) is a clinical syndrome characterized by progressive dissolution of language with relative preservation of other cognitive abilities for at least 1 to 2 years. Recent studies have classified the clinical presentations of PPA into three main subtypes: agrammatic, logopenic, and semantic variant.