We read with great interest the recent report on acute aphasia in patients with multiple sclerosis (MS) by Devere and coworkers1 in the August issue of the ARCHIVES. The authors described 3 patients with clinically definite MS who had acute exacerbations presenting as aphasia. Magnetic resonance imaging (MRI) scans of the brain with contrast enhancement revealed new white matter lesions in the left hemisphere in all 3 patients. Two of the 3 patients responded well to treatment with corticosteroids. Due to the impairment of linguistic functions like naming or speech comprehension, MS-related aphasia can be differentiated from paroxysmal dysarthria, another speech disorder found in MS, which presents as the sudden appearance of motor speech impairment or mutism, usually combined with limb ataxia, which probably originates from ephaptic conduction in the brainstem.2 Though the existence of MS-related aphasia has been known for a long time,3 Devere and coworkers underlined the paucity of reports of this phenomenon. However, in their report, the electroencephalogram (EEG) results were not presented, and status aphasicus or postictal aphasia cannot be excluded on the basis of the clinical features alone.
Trinka E, Unterberger I, Luef G, Benke T, Berger T, Bauer G. Acute Aphasia in Multiple Sclerosis. Arch Neurol. 2001;58(1):133-134. doi: