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A Case of Oral Spelling Behavior: Another Environmental Dependency Syndrome

Paquier, Claire Ragno MSc*; Assal, Frédéric MD

Cognitive and Behavioral Neurology: December 2007 - Volume 20 - Issue 4 - p 235-237
doi: 10.1097/WNN.0b013e31814da110
Case Reports
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Objective To present the case of a woman with a probable vascular dementia and a unique oral spelling behavior (OSB). Our aim was to better characterize the mechanisms underlying OSB in this patient with advanced cognitive and noncognitive deficits.

Background Different kind of language deficits have been described in dementias and other related diseases. Other nonaphasic acquired communication disorders include a heterogeneous group of verbal impairment that are mainly due to attentional and executive impairments.

Methods We describe the neurolinguistic and neuropsychologic analysis of an 88-year-old woman with spontaneous OSB. Computed tomography-scan at the time of the clinical analysis is also presented.

Results OSB occurred preferentially in spontaneous discourse, manifested in other language tasks, concerned all lexical categories, and was not accompanied by spelling deficit although language was not intact and disclosed foreign accent syndrome. Environmental dependency syndrome or utilization behavior was prominent and concerned various sensorimotor activities.

Conclusions We postulate that OSB was not secondary to a linguistic or more specifically to a spelling deficit but to another variant of environmental dependency syndrome and probably associated with a cortico-subcortical lesion including the left prefrontal region.

*Geriatric Psychiatry Clinic, Department of Psychiatry, HUG, Petit-Bel-Air 2, 1225 ChêneBourg

Neurology Clinic, Department of Clinical Neurosciences, HUG, Micheli-du-Crest 24, 1211 Geneva, Switzerland

Reprints: Frédéric Assal, MD, Neurology Clinic, Department of Clinical Neurosciences, HUG, Micheli-du-Crest 24, 1211 Geneva, Switzerland (e-mail: frederic.assal@hcuge.ch).

Received for publication April 5, 2007; accepted July 4, 2007

© 2007 Lippincott Williams & Wilkins, Inc.