Pearls & Oy-sters: Huntington Disease Presenting as Primary Progressive Aphasia: A Case of Semantics

Neurology. 2023 Aug 29;101(9):414-417. doi: 10.1212/WNL.0000000000207428. Epub 2023 May 18.

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.

Publication types

  • Case Reports

MeSH terms

  • Aphasia, Primary Progressive* / diagnostic imaging
  • Aphasia, Primary Progressive* / etiology
  • Brain / diagnostic imaging
  • Humans
  • Huntington Disease* / diagnosis
  • Huntington Disease* / diagnostic imaging
  • Magnetic Resonance Imaging
  • Neurodegenerative Diseases*
  • Positron Emission Tomography Computed Tomography
  • Semantics