[Slowly progressive dysarthria and impaired language function--a case report]

Area of Science:

• Neuroscience
• Neurology
• Geriatrics

Background:

• Investigating progressive neurological disorders presenting with speech and writing impairments.
• Understanding the clinical and radiological correlates of atypical aphasia and dysarthria.

Observation:

• A 68-year-old woman presented with a 2-year history of slowly progressive dysarthria and writing disability.
• Clinical examination revealed severe dysarthria resembling pseudobulbar palsy with effortful speech, oro-facial apraxia, and impaired word fluency, repetition, and writing.
• Cognitive assessment showed preserved verbal comprehension and naming, normal verbal IQ, mild frontal dysfunction, and no generalized intellectual deterioration.

Findings:

• Magnetic resonance imaging (MRI) revealed cortical atrophy in the bilateral frontal and temporal lobes.
• 18F-FDG-PET demonstrated reduced metabolic activity in the latero-dorso-inferior regions of the bilateral frontal lobes, particularly on the left.
• The patient exhibited progressive aphasia and dysarthria without generalized dementia or typical aphasic syndromes.

Implications:

• The observed symptoms are potentially linked to the identified frontal and temporal lobe atrophy and reduced frontal lobe metabolism.
• This case highlights a distinct pattern of neurodegeneration affecting speech and language without global cognitive decline.
• The underlying pathological process remains undetermined, warranting further investigation into rare neurodegenerative conditions.