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Progressive Supranuclear Palsy with Predominant Speech/Language Disorder
Shinichiro Maeshima1, Keita Sakurai1, Aiko Osawa1
1National Center for Geriatrics and Gerontology, Japan.
Internal Medicine (Tokyo, Japan)
|October 8, 2025
Summary
This rare progressive supranuclear palsy (PSP) case initially showed fluent aphasia and echolalia. Recognizing these atypical presentations is crucial for early diagnosis and intervention in non-classical PSP.
Area of Science:
- Neurology
- Neurodegenerative Diseases
Background:
- Progressive Supranuclear Palsy (PSP) typically presents with motor symptoms.
- Atypical presentations of PSP can mimic other neurodegenerative disorders, delaying diagnosis.
Purpose of the Study:
- To report a rare case of PSP with initial language-dominant symptoms.
- To emphasize the importance of identifying atypical PSP presentations.
Main Methods:
- Case report of a 75-year-old woman.
- Detailed neuropsychological assessments.
- Neuroimaging (MRI/SPECT) revealing atrophy and hypoperfusion.
Main Results:
- The patient presented with 2 years of fluent aphasia and echolalia before motor symptoms (vertical gaze palsy, falls).
- Neuroimaging showed asymmetric frontal/midbrain atrophy and left frontal/parietal hypoperfusion.
Conclusions:
- Language-dominant PSP variants can mimic other neurodegenerative conditions.
- Early identification through comprehensive assessments and imaging is vital for non-classical PSP cases.
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