|
1
|
Clarke AJ, Manser D, Fleischer R, Fulham M, Ahmed RM. Pearls & Oy-sters: Huntington Disease Presenting as Primary Progressive Aphasia: A Case of Semantics. Neurology 2023; 101:414-417. [PMID: 37202171 PMCID: PMC10501099 DOI: 10.1212/wnl.0000000000207428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/04/2023] [Indexed: 05/20/2023] Open
Abstract
We present a case of semantic variant primary progressive aphasia as the presenting feature in a patient with Huntington disease (HD). The patient initially developed progressive language impairment including impaired naming and object knowledge and single-word comprehension and then developed chorea and behavioral changes. An MRI of the brain showed left anterior temporal lobe and hippocampal atrophy. A neurologic FDG PET/CT showed reduced metabolism in the head of the left caudate nucleus. Huntingtin gene testing revealed an expansion of 39 CAG repeats in 1 allele. This case outlines the substantial overlap between the clinical presentation of HD and frontotemporal lobar degeneration syndromes and provides commentary on the investigation of these neurodegenerative diseases.
Collapse
Affiliation(s)
- Antonia J Clarke
- From the Faculty of Medicine and Health (A.J.C., R.M.A.), University of Sydney; Department of Neurology (A.J.C., D.M., M.F., R.M.A.), Genetics Department (R.F.), and Department of Molecular Imaging (M.F.), Royal Prince Alfred Hospital; and Faculty of Engineering and Computer Science (M.F.), University of Sydney, Australia.
| | - David Manser
- From the Faculty of Medicine and Health (A.J.C., R.M.A.), University of Sydney; Department of Neurology (A.J.C., D.M., M.F., R.M.A.), Genetics Department (R.F.), and Department of Molecular Imaging (M.F.), Royal Prince Alfred Hospital; and Faculty of Engineering and Computer Science (M.F.), University of Sydney, Australia
| | - Ronald Fleischer
- From the Faculty of Medicine and Health (A.J.C., R.M.A.), University of Sydney; Department of Neurology (A.J.C., D.M., M.F., R.M.A.), Genetics Department (R.F.), and Department of Molecular Imaging (M.F.), Royal Prince Alfred Hospital; and Faculty of Engineering and Computer Science (M.F.), University of Sydney, Australia
| | - Michael Fulham
- From the Faculty of Medicine and Health (A.J.C., R.M.A.), University of Sydney; Department of Neurology (A.J.C., D.M., M.F., R.M.A.), Genetics Department (R.F.), and Department of Molecular Imaging (M.F.), Royal Prince Alfred Hospital; and Faculty of Engineering and Computer Science (M.F.), University of Sydney, Australia
| | - Rebekah M Ahmed
- From the Faculty of Medicine and Health (A.J.C., R.M.A.), University of Sydney; Department of Neurology (A.J.C., D.M., M.F., R.M.A.), Genetics Department (R.F.), and Department of Molecular Imaging (M.F.), Royal Prince Alfred Hospital; and Faculty of Engineering and Computer Science (M.F.), University of Sydney, Australia
| |
Collapse
|
|
2
|
Schulze Westhoff M, Osmanovic A, Meissner C, Heck J, Mahmoudi N, Hendrich C, Berding G, Seifert J, Bleich S, Frieling H, Krüger T, Groh A. An unusual presentation of Huntington's disease. Clin Case Rep 2021; 9:e04547. [PMID: 34295499 PMCID: PMC8283861 DOI: 10.1002/ccr3.4547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/13/2021] [Indexed: 01/25/2023] Open
Abstract
We describe the case of a 59-year-old woman who exhibited psychotic symptoms, cognitive dysfunction, and restlessness. While the clinical picture and 18F-FDG PET/CT suggested the presence of a tauopathy, especially frontotemporal dementia or progressive supranuclear palsy, genetic testing eventually revealed Huntington's disease.
Collapse
Affiliation(s)
- Martin Schulze Westhoff
- Department of PsychiatrySocial Psychiatry and PsychotherapyHannover Medical SchoolHannoverGermany
| | - Alma Osmanovic
- Department of NeurologyHannover Medical SchoolHannoverGermany
| | - Catharina Meissner
- Department of PsychiatrySocial Psychiatry and PsychotherapyHannover Medical SchoolHannoverGermany
| | - Johannes Heck
- Institute for Clinical PharmacologyHannover Medical SchoolHannoverGermany
| | - Nima Mahmoudi
- Department of Diagnostic and Interventional NeuroradiologyHannover Medical SchoolHannoverGermany
| | - Corinna Hendrich
- Institute for Human GeneticsHannover Medical SchoolHannoverGermany
| | - Georg Berding
- Department of Nuclear MedicineHannover Medical SchoolHannoverGermany
| | - Johanna Seifert
- Department of PsychiatrySocial Psychiatry and PsychotherapyHannover Medical SchoolHannoverGermany
| | - Stefan Bleich
- Department of PsychiatrySocial Psychiatry and PsychotherapyHannover Medical SchoolHannoverGermany
| | - Helge Frieling
- Department of PsychiatrySocial Psychiatry and PsychotherapyHannover Medical SchoolHannoverGermany
| | - Tillmann Krüger
- Department of PsychiatrySocial Psychiatry and PsychotherapyHannover Medical SchoolHannoverGermany
| | - Adrian Groh
- Department of PsychiatrySocial Psychiatry and PsychotherapyHannover Medical SchoolHannoverGermany
| |
Collapse
|