Case 15 - Young man with progressive speech impairment and weakness  pp. 105-114

By Aiman Sanosi, Ian R. A. Mackenzie and Ging-Yuek Robin Hsiung

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Clinical history – main complaint

Mr. J is a 54-year-old right-handed man brought to medical attention by his daughter because of progressive speech difficulty over the last 2 years.

General history

Mr. J actually denied having any problems himself. However, the collateral history obtained from his daughter suggested that his speech fluency has declined and he was much slower to respond to conversations. For example, when he was asked a question, it would take him about 10–20 seconds to actually think of the answer, and when he did respond, his speech revealed a paucity of words with frequent word finding difficulty. The daughter also noticed that there was a change in his speech pattern as he was making more syntax errors with increased hesitancy. There was no obvious problem with reading and writing, although he was never a good writer. There was no history of word or phrase repetition either spontaneously or in response to questions. His comprehension of speech and knowledge of meaning of the words were relatively intact.

One year prior to presentation, his daughter has noticed some changes in his behavior. For example, he seem to be more impulsive with his shopping habits, as he was spending money on items that he did not really need, or on things that were way over his budget. She felt that there was a definite decline in judgment over his financial matters. In addition, the daughter said that he was more disorganized and easily distractible.

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