EXPRESSIVE APHASIA IN CONGENITAL RUBELLA SYNDROME

Abstract

Language disorders in children with congenital rubella syndrome (CRS) have usually been associated with autism, deafness or mental retardation, or to some combination of these. The present report concerns a child with CRS and expressive aphasia not attributable to the three named causes.This now 12 year old girl was born in Sept. 1964 to a mother who was exposed to and had symptoms consistent with rubella near the time of conception. Pregnancy lasted 42 weeks; birth wt. was 2380 gm (older sibs were 3600 and 4500 gm). No abnormalities were noted then or later. She could drink fluids without difficulty; she choked frequently on solids. There was drooling and “snorting” throughout childhood. Development was age-appropriate except for speech. She said “mama” at age 16 mos. but never progressed further. At age 4 a neurologist suggested an isolated bulbar palsy as the cause of the speech disorder. EEG was normal. Hearing is entirely normal. She is in an age-appropriate grade in public school, communicating with the aid of the sign language of the deaf, which has been taught to her by volunteers. She is aphasic with severe motor involvement of the lips and tongue. Performance is good on non-verbal developmental tests.In the evaluation of language disorders in children with CRS isolated neuromuscular disease such as shown by this patient should be considered.