September 2017

56-year-old with speech difficulty

History

A 56-year-old female presents with one week of worsening memory, trouble finding words and using the wrong words intermittently. Her family also feels she is withdrawn. She is a non smoker and has no history of cancer. No serious medical problems.

Exam

Awake, alert, able to name normally, trouble with repetition and occasionally uses inappropriate word, paucity of spontaneous speech
Cranial nerves II-XII are intact
Strength- 5/5 upper extremities
No sensory loss
DTR wnl Cerebellar function and gait are normal

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Questions

Please subit your answers to see the case explanation.

Refrences:

  • Stupp et al. Maintenance Therapy With Tumor-Treating Fields Plus Temozolomide vs Temozolomide Alone for Glioblastoma: A Randomized Clinical Trial. JAMA 2015.
  • Chinot et al. Bevacizumab plus radiotherapy-temozolomide for newly diagnosed glioblastoma. NEJM, 2014.
  • Gilbert et al. A randomized trial of bevacizumab for newly diagnosed glioblastoma. NEJM, 2014.

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