Piusińska-Macoch Renata, Stepień Adam
Department of Neurology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine in Warsaw, Poland.
Pol Merkur Lekarski. 2011 Sep;31(183):175-8.
Originally progressive aphasia (primary progressive aphasia - PPA) is a specific clinical syndrom, recognized as one of three forms fronto-temporal lobar degeneration (FTLD). This group also includes fronto-temporal dementia (FTD) and semantic dementia (SD). The classification of Bonner et al distinguished three variants of PPA: logopenic, agrammatic and semantic PPA. The aim of the study was an attempt to analyze the complex, rarely recognized clinical syndrome that is primary progressive aphasia with the latest diagnostic criteria. This paper presents a case of the 55-year old woman with impaired language disorders in the form of PPA. In the diagnostic process, with repeated measurements, we used the results of physical examinations, neurological, psychological, EEG, brain imaging to the evaluation of structural and metabolic changes in MRI and PET biochemical tests of cerebrospinal fluid, without the possibility of morphological verification. Psychological assessment was performed by clinical experiment with the use of psychometric scales - WAIS-R, BVRT, Rey's figure, Stroop Test, RHLB, The Trail Making Test and clinical trials - Łucki W. Papers. Based on the latest, differential criteria for this syndrome, semantic variant of primary progressive aphasia diagnosis was made.
The use of the latest classification of a PPA seems to be an interesting proposition to improve methods for identifying, testing and treatment of this complex clinical syndrome. On each stage of the diagnostic and therapeutic process, patient required individually adjusted neuropsychological cognitive and executive functions rehabilitation.
原发性进行性失语(原发性进行性失语 - PPA)是一种特定的临床综合征,被认为是额颞叶变性(FTLD)的三种形式之一。该组还包括额颞叶痴呆(FTD)和语义性痴呆(SD)。邦纳等人的分类区分了PPA的三种变体:音韵性失语、语法缺失性失语和语义性PPA。本研究的目的是尝试用最新的诊断标准分析原发性进行性失语这种复杂且鲜为人知的临床综合征。本文介绍了一名55岁女性以PPA形式出现语言障碍受损的病例。在诊断过程中,通过重复测量,我们使用了体格检查、神经学、心理学、脑电图、脑成像结果来评估MRI中的结构和代谢变化以及脑脊液的PET生化测试,但无法进行形态学验证。心理评估通过使用心理测量量表——韦氏成人智力量表修订版(WAIS - R)、本顿视觉保持测验(BVRT)、雷氏图形、斯特鲁普测验、修订版霍普金斯词语学习测验(RHLB)、连线测验以及临床试验——卢茨基论文进行临床实验。根据该综合征的最新鉴别标准,做出了原发性进行性失语语义变体的诊断。
使用PPA的最新分类似乎是改进这种复杂临床综合征的识别、测试和治疗方法的一个有趣提议。在诊断和治疗过程的每个阶段,患者都需要进行个体化调整的神经心理认知和执行功能康复。