Ardila Alfredo, Matute Esmeralda, Inozemtseva Olga V
Communication Sciences and Disorders, Florida International University, Miami, Florida 33182, USA.
Appl Neuropsychol. 2003;10(4):205-14. doi: 10.1207/s15324826an1004_2.
A case of a 50-year-old, right-handed female, mono-lingual native Spanish-speaker with a university-level education and cognitive changes is reported. Over approximately 2 years, she presented with a progressive deterioration of writing abilities associated with acalculia and anomia. An MRI disclosed a left parietal temporal atrophy. Two years later, further significant cognitive decline consistent with a dementia of the Alzheimer's type was observed. Amnesia, executive dysfunction, and ideomotor apraxia were found. Writing was severely impaired, and some difficulties in reading were observed. Copying abilities, however, were relatively well preserved, and the patient could drive and go to different city locations without significant spatial orientation difficulties. A second MRI approximately 2 years later showed that brain atrophy had progressed significantly. Spontaneous writing and writing to dictation were impossible. The ability to read words was preserved, but the ability to read pseudowords was lost. Changes in calligraphy were noted. This case clearly illustrates the progression of focal cognitive defects over time and the spread of abnormalities to other domains.
报告了一例50岁的右利手女性病例，她是单语母语为西班牙语者，具有大学文化水平且存在认知改变。在大约两年的时间里，她出现了与失算症和命名障碍相关的书写能力逐渐衰退的情况。磁共振成像（MRI）显示左侧顶颞叶萎缩。两年后，观察到进一步的显著认知衰退，符合阿尔茨海默病型痴呆。发现存在失忆、执行功能障碍和观念运动性失用症。书写严重受损，并且观察到一些阅读困难。然而，抄写能力相对保留较好，患者能够开车前往不同的城市地点，没有明显的空间定向困难。大约两年后的第二次MRI显示脑萎缩显著进展。自发书写和听写都无法进行。读词能力保留，但读假词能力丧失。注意到书法有变化。该病例清楚地说明了局灶性认知缺陷随时间的进展以及异常向其他领域的扩散。
