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SUMMARY Spontaneous language of 18 patients suffering from Huntington's disease and 15 dysarthric controls suffering from Friedreich's ataxia were investigated. In addition, language functions in various modalities were assessed with the Aachen Aphasia Test (AAT). The Huntington patients exhibited deficits in the syntactical complexity of spontaneous speech and in the Token Test, confrontation naming, and language comprehension subtests of the AAT, which are interpreted as resulting from their dementia. Errors affecting word access mechanisms and production of syntactical structures as such were not encountered.A participation of the basal ganglia not only in articulatory motor but also in language functions has repeatedly been proposed (for a review, see ref 1), and aphasia with vascular lesions of the left caudate and lenticular nuclei has been reported in a number of cases. 2 5 If, however, the basal ganglia were indeed crucial in language production, as has been stated by Brunner et al,2 then degenerative diseases should also result in language deficits, and, if they were involved in linguistic processes, their chronic pathology should lead to abnormalities of phonological, lexical and/or syntactical aspects. If, on the other hand, only motor6 or motor and behavioural7 aspects of the use of language were concerned, these linguistic features should adapt in a rule-governed and systematic way to the nonlinguistic impairment.

Lithium intoxication presents with a plethora of symptoms. Especially in elderly patients, prompt diagnosis can be delayed as intoxication can mimic symptoms of co-morbidities. We present and discuss a patient with multiple diseases, who presented in an acute confusional state due to lithium intoxication.

ZusammenfassungDie posteriore kortikale Atrophie (PCA) ist eine seltene neurodegenerative Erkrankung, die mit komplexen Sehstörungen einhergeht. Sie kann isoliert („PCA-pure“) oder zusammen mit anderen neurodegenerativen Störungen („PCA-plus“) auftreten. Die Diagnosestellung erfolgt meistens verzögert, da die Erkrankung wenig bekannt ist und oftmals initial eine ophthalmologische Ursache vermutet wird.