Writing errors and anosognosia in amyotrophic lateral sclerosis with dementia.

Abstract:

:Amyotrophic lateral sclerosis (ALS) with dementia (ALS-D) is known to exhibit characteristics of frontotemporal dementia. However, in clinical situations, it is often difficult to evaluate their cognitive functions because of impaired voluntary speech and physical disabilities. In order to identify characteristic and diagnostic cognitive symptoms of relatively advanced ALS-D patients, we retrospectively reviewed the clinical features of seven cases of clinically definitive ALS who had dementia, impaired voluntary speech, and physical disability. Their medical records showed that six out of seven patients made writing errors, and all of the patients demonstrated anosognosia. The writing errors consisted of paragraphia such as substitution, omission, or syntactic errors with individual differences in error types. Dissociation between kana and kanji were also observed. Anosognosia was evaluated by a self-rating scale with which the patients and the medical staff evaluated the patient's physical ability; the results indicated a large discrepancy between the evaluation by the patients and the medical staff. We emphasize that aphasic writing errors have been underestimated, particularly in ALS-D patients with impaired voluntary speech. We also reported that anosognosia was the most important and quantifiable symptom in ALS-D. The relationship between writing errors and anosognosia should be investigated further.

journal_name

Behav Neurol

journal_title

Behavioural neurology

authors

Ichikawa H,Koyama S,Ohno H,Ishihara K,Nagumo K,Kawamura M

doi

10.1155/2008/814846

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

107-16

issue

3

eissn

0953-4180

issn

1875-8584

journal_volume

19

pub_type

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