Po1300 A Patient With Speech Disorder

Selcuk Y?ld?z1, Sevim Ogulmus1, Tuba Agac Vural1, Tuncer Kilic2, Yusuf Ustu3 e Mehmet Ugurlu4
1Ankara Atatürk Training and Research Hospital, Department of Family Medicine; 2Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Family Medicine; 3Yildirim Beyazit University, Faculty of Medicine, Department of Family Medicine; 4Y?ld?r?m Beyaz?t University, Faculty of Medicine, Department of Family Medicine
INTRODUCTION: Multiple sclerosis(MS) is a chronic autoimmune, inflammatory neurological disease of the central nervous system (CNS). We report the case of a patient presented with difficulty of speech and diagnosed as Multiple sclerosis.
CASE REPORT:35-year-old male patient applied to our clinic with the complaining about speech disorder. He explained that he had difficulty in speech while pronouncing the words during the conversation for nearly 2 months. He had no another systemic disease. Family history was unremarkable. On the systematic examination consciousness, orientation and co-operation status was normal. Speech was dysarthric, and other cranial nerves, brain stem functions were normal. Deep tendon reflexes were hyperactive in the upper and lower extremities, cerebellar tests were normal, Romberg was negative. Laboratory findings were normal. Magnetic resonance imaging revealed a number of lesions in the white substance of the cerebrum and is thought that it could be MS.
DISCUSSION: MS typically presents in adults 20 to 45 years of age; occasionally, in childhood or late middle age. The cause is unknown, but it appears to involve a combination of genetic susceptibility and a non-genetic trigger, such as a virus, metabolism, that together result in a self-sustaining autoimmune disorder that leads to recurrent immune attacks on the CNS. Common symptoms of MS include spasticity, fatigue, sexual dysfunction, bladder dysfunction, cognitive dysfunction, depression, bowel dysfunction. Magnetic resonance imaging of the brain and spine may show areas of demyelination. A combination of drugs and physical, speech, and occupational therapies; exercise; rest; and healthful nutrition may relieve symptoms and promote a satisfactory quality of life. Early diagnosis and early treatment are critical to prevent irreversible long-term sequelae in patients with MS. Primary care physicians can often be the first point of contact for patients with MS. They should be aware of these symptoms for the first diagnose and MS relapses. Primary care physicians should refer patients to a neurologist for further assessment, including an MRI, suggesting the first clinical demyelinating event. Moreover, it is important to educate patients regarding the signs and symptoms of MS and to gain their full cooperation to optimize disease management. Patients should be able to recognize the symptoms of MS so that they would be able to inform their physician better about their status.
speech disorder; multiple sclerosis;Primary care