Swallowing difficulty in primary progressive aphasia: a case report.

A 71-year-old right handed man showed insidious and progressive decline of language skills, in contrast with relatively preserved performance on tests and ability to be independent in daily living. Three years later, he developed swallowing difficulties. MRI scans showed widening of the left sylvian fissure. A SPECT scan demonstrated focal hypometabolism restricted to the left temporal lobe. Videofluoroesophagography revealed marked hesitation of oral preparation and oral phases, while the reflex phases were unimpaired. The patient failed to perform oral tasks on command and imitation without motor and sensory deficit. We believe that his swallowing difficulty was due to oral apraxia. This case adds to the heterogeneity of patients with primary progressive aphasia.