A case report of somatic symptom disorder as first manifestation of semantic dementia

Abstract

Semantic dementia (SD) is a progressive neurodegenerative disorder in which patients present a loss of meaning of words, objects, and concepts. SD has been linked with alexisomia, as well as somatic symptom disorder (SSD). A 65 year-old patient with a 2-year history of daily episodes of pulsatile head and chest sensations followed by prostration with maintained awareness was diagnosed with SSD. The patient was subsequently admitted into an epilepsy unit to exclude the diagnosis of epileptic seizures. Clinical, neuropsychological, and neuroimaging assessments were consistent with the diagnosis of probable SD. This case report presents a patient whose first manifestation of SD was SSD, thus highlighting the importance of both careful clinical and neurocognitive enquiry, and caution in diagnosing SSD in later life. This case outlines the association between SD and somatic symptoms, providing insight into the nature of alexisomia and the emergence of SSD in SD.