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Case 14 - Progressive difficulty producing speech

Published online by Cambridge University Press:  16 May 2011

Serge Gauthier
Affiliation:
McGill University, Montréal
Pedro Rosa-Neto
Affiliation:
McGill University, Montréal
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Summary

This chapter talks about an 83-year-old man with a 3-4-year history of progressive speech difficulty. Past medical history was remarkable for hypertension and ischemic heart disease. Psychiatric history was unremarkable. General neurological exam was remarkable for bilateral cogwheeling in the upper extremities, rigid posture, and bilateral decreased arm swing. Magnetic Resonance Imaging (MRI) of the brain showed diffuse atrophy. Single-Photon Emission Computed Tomography (SPECT) showed decreased perfusion in the left temporo-parietal region. The findings suggested a diagnosis of progressive non-fluent aphasia (PNFA). The possibility of corticobasal syndrome (CBS) was also raised. A variety of neuropathological changes have been associated with PNFA. The most common are non-Alzheimer tauopathies. Alzheimer pathology has also being identified in PNFA, with some reports showing these in up to 30% of cases. In these patients, the distribution of AD pathology may be unusual, showing a frontotemporal pattern.
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Chapter
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Case Studies in Dementia
Common and Uncommon Presentations
, pp. 98 - 104
Publisher: Cambridge University Press
Print publication year: 2011

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