Diagnóstico diferencial na Afasia Progressiva Primária

• DOI: 10.22533/at.ed.1432207108

• Palavras-chave: diagnóstico diferencial, afasia progressiva primária, demência

• Keywords: differential diagnosis, primary progressive aphasia, dementia

• Abstract:

  Primary Progressive Aphasia (PAS) is a neurodegenerative clinical syndrome that primarily affects insidiously onset communication and progressive worsening, which is of great interest for its particular presentation that distinguishes it from aphasias secondary to focal lesions (classical aphasias) and also of dementia diseases.

  Preliminarily his presentation is directly linked to language in which there is difficulty in naming, a presentation similar to the early stage of Alzheimer's disease.

  Secondly, the diagnostic methods must establish that the disease is neurodegenerative, therefore, of progressive intrinsic aspect. Ultimately, the clinical presentation of aphasia should be isolated, ie, without episodic memory changes or behavioral attitudes.

  Objectives: Report a case of logopenic APP, perform a review of the specialized medical literature. Discuss the importance of correct diagnosis and differential diagnoses.

  Case report: A 62-year-old woman previously diagnosed with early semantic dementia, which directly affects her activities of daily living. It is dependent on accompaniment during its activities because it has confusing, disjointed and impoverished vocabulary, as well as poor time-space orientation. The ability to recognize written words remains preserved, but there is explicit difficulty in associating word with image. The family reports worsening of the picture as the years go by, with a clear worsening of the interaction, little fluent speech, difficulty in naming. MRI has dilatation of the supratentorial ventricles, mild hypersignal FLAIR and T2 in predominant periventricular cerebral white matter in the frontal regions and slight diffuse cerebral volume reduction.

  Conclusions: The logopenic form of Primary Progressive Aphasia (PPA), presentation of the condition of the patient in question, manifests itself with language impairment with slow, slow-paced speech and long pauses and repetition of words. Repetition and comprehension for sentences of more complex grammatical structure are compromised, as well as the association between word and image, but the comprehension of isolated words remains preserved. There may also be limitations of short-term auditory-verbal memory and impaired temporary storage of information. Alzheimer's disease is the main differential diagnosis of PPA.