Abstract
A patient with progressive dementia, prominent non-fluent aphasia and signs of frontal lobe involvement, was evaluated by neuropsychological testing, magnetic resonance imaging (MRI) and high resolution single photon emission tomography (SPET). The presence of severe bucco-facial apraxia, associated with spared imitation of limb movements, correlated well with a marked reduction of cerebral perfusion in the left fronto-temporal cortex. This case emphasizes the usefulness of SPET as a valuable alternative to PET for the diagnosis of conditions, such as progressive neuropsychological syndromes, where a coupled reduction of metabolism and blood flow can be expected.
Highlights
We report the case of a patient with a progressive dementia, characterized by severe deterioration of language and neuropsychological signs of frontal lobe involvement, who had a severe bucco-facial apraxia and a flawless performance on tests of limb praxis
Total lack of cooperation prevented further neuropsychological reassessment. This patient presented with a progressive dementia, characterized by severe language impairment and by a bucco-facial apraxia; on the other hand, imitation of limb movements was excellent
single photon emission tomography (SPET) indicated a severe left fronto-temporal hypoperfusion: the functional findings were in agreement with the prevalent left fronto-temporal atrophy shown by magnetic resonance imaging (MRI)
Summary
We report the case of a patient with a progressive dementia, characterized by severe deterioration of language and neuropsychological signs of frontal lobe involvement, who had a severe bucco-facial apraxia and a flawless performance on tests of limb praxis. The clinical picture suggested relatively selective pathological involvement in the fronto-temporal areas of the left hemisphere. Regional cerebral perfusion was assessed with high resolution single photon emission tomography (SPET). The imaging results were in agreement with the clinical findings, and comparable to the positron emission tomography (PET) findings reported by Tyrrell et at. (1991) in three patients with a similar clinical presentation
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