Primary progressive aphasia presenting as possible conversion disorder.

Area of Science:

• Neurology
• Psychiatry
• Linguistics

Background:

• Primary progressive aphasia (PPA) is a neurodegenerative disorder affecting language abilities.
• Atypical presentations of PPA can mimic other neurological and psychiatric conditions, complicating diagnosis.
• This case illustrates the diagnostic challenges in identifying PPA, especially in its early stages.

Purpose of the Study:

• To present a challenging case of primary progressive aphasia (PPA).
• To discuss the diagnostic overlap between PPA, conversion disorder, frontotemporal dementia, and Alzheimer's disease.
• To emphasize the importance of a multidisciplinary approach in diagnosing PPA.

Main Methods:

• Case report detailing a 62-year-old woman with a six-year history of progressive speech and language difficulties.
• Clinical assessment including evaluation for neurological and psychiatric conditions.
• Discussion of diagnostic considerations and differential diagnoses.

Main Results:

• The patient presented with symptoms overlapping with conversion disorder, frontotemporal dementia, and early Alzheimer's disease.
• Despite significant language decline, the patient maintained independence in daily living and continued working for an extended period.
• The case underscores the diagnostic complexity of PPA.

Conclusions:

• Primary progressive aphasia can present with overlapping symptoms, posing a diagnostic challenge.
• A high index of suspicion, sensitive investigations, and a multidisciplinary team are crucial for accurate PPA diagnosis.
• Missed or delayed diagnosis of PPA can occur if not adequately investigated, especially at different disease stages.