Acute Aphasia in Multiple Sclerosis

Abstract

Acute aphasia is rare in multiple sclerosis. We describe 3 patients with multiple sclerosis who had acute exacerbations presenting as aphasias. One patient had a mixed transcortical aphasia, 1 had a transcortical motor aphasia, and 1 had a Broca aphasia. Magnetic resonance imaging scans of the brain with contrast enhancement revealed new white matter lesions in the left hemisphere in all 3 patients. Two of the 3 patients had a good response to treatment with methylprednisolone sodium succinate. Arch Neurol. 2000;57:1207-1209

Aphasia in Multiple Sclerosis

“…In conclusion acute aphasia may present as an exacerbation of the disease in MS [3]. The involvement of the cortical white matter junctions including all the anatomic structures, which are responsible for language function, may have caused the global aphasia.…”

“…The concept of diaschisis, whereby impaired function occurs in one area of the brain secondary to an acute focal lesion in a more distant part of the brain, has been cited as one explanation for subcortical lesions causing aphasia [3]. Since demyelinating lesions frequently affect subcortical region [1], and the involvement of these regions by plaques is frequently shown at post-mortem examination [8], it seems puzzling why aphasia is so uncommon in MS [1].…”

“…Most of the cases with aphasia reported in literature are the patients with motor aphasia [1,2,3,8]. Arnett et al [2] reported an MS patient with conduction aphasia associated with a large white matter lesion underlying the left supramarginal gyrus [2].…”

“…It has been reported that five patients with MS presenting aphasia have giant plaques on the MRI scan [1,3]. Therefore the reason of aphasia being a rarity in the MS literature may be the fact that patients have unusually large white matter lesions extending close to the cortical surface [2].…”

Sclerosis multiplex stroke jellegű tünetekkel: kihívó diagnózis egy eset kapcsán

“…Az említett forma ritkán hiperakut, stroke-szerű formában is megjelenhet [5], ezekről időnként közlések jelentek meg a szakirodalomban [6,7]. Utóbbi klinikai kép megtévesztő lehet a diagnózis szempontjából; a közölt esetekben mind hemiparesis, mind afázia előfordult, más közlések tisztán afáziás relapsusokról számoltak be [8,9]. Munkánk cél-kitűzése egy stroke-szerű tünetekkel beutalt, valószínű-síthetően SM-betegnél tapasztalt diagnosztikai jellegzetességek bemutatása.…”