When PPA is not only about PPA - a case report of a female patient with primary progressive aphasia and functional speech disorder

Abstract

Primary progressive aphasia (PPA) is a clinical syndrome caused by a neurodegenerative process. PPA is characterised by a progressive disruption of the language system, which limits the patient in activities of daily living. The symptoms of this disease mostly manifest around 50 years of age, but are often seen in a much younger population. Acquaintance with this kind of diagnosis represents a certain psychological burden to the patient. Coping with it depends on the patient's personality traits (Nash, Hutner and Caligor, 2014). Inadequate stress processing can lead to development of a functional movement disorder (Thenganatt and Jankovic, 2015). Here we present a case report of a 38-year-old female patient with a 3-year history of a speech disorder. She subjectively stated difficulties, mainly related to word finding difficulties and garbled words. The patient underwent a comprehensive neurological examination. A PET CT scan was performed, with findings of changes corresponding to lvPPA. Shortly after the diagnosis was announced, the patient began to experience changing patterns of motor speech impairment, which significantly limit the further diagnostic and therapeutic processes. A psychological and psychiatric examination was recommended to the patient. This case report draws attention to the importance of multidisciplinary cooperation.