Fuh J L, Liao K K, Wang S J, Lin K N
Neurological Institute, Veterans General Hospital, Taupei, Taiwan, Republic of China.
Cortex. 1994 Dec;30(4):701-5. doi: 10.1016/s0010-9452(13)80246-8.
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.
一名71岁右利手男性表现出隐匿性和进行性的语言技能衰退，与之形成对比的是，其在测试中的表现相对保留，且具备独立的日常生活能力。三年后，他出现吞咽困难。磁共振成像（MRI）扫描显示左侧大脑外侧裂增宽。单光子发射计算机断层扫描（SPECT）显示仅左侧颞叶存在局灶性代谢减低。电视荧光吞咽造影显示口腔准备期和口腔期明显延迟，而反射期未受影响。患者在无运动和感觉缺陷的情况下，无法按指令和模仿完成口腔任务。我们认为他的吞咽困难是由口腔失用症引起的。该病例增加了原发性进行性失语症患者的异质性。
