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• Vol.59 No.6
• CLINICA NEUROL, 59: 356−359, 2019
• Vol.59 No.6 contents

Case Report

A case of angioedema with dysarthria mimicking transient ischemic attack

Rika Tanaka, M.D.¹⁾, Seiji Gotoh, M.D.²⁾, Mitsuhiro Yasuda, M.D.¹⁾ and Manabu Takamatsu, M.D.¹⁾

¹⁾Department of emergency, National Hospital Organization, Kyushu Medical Center
²⁾Department of cerebrovascular medicine and neurology, National Hospital Organization, Kyushu Medical Center

An 85-year-old woman was transported to our emergency room by ambulance with a complaint of slurred speech. Neurological examination revealed dysarthria only. We considered that lingual edema identified on physical examination might have influenced dysarthria. However, we were unable to perform sufficient evaluation, since she could not open her mouth widely or push the tongue out beyond the lips. We considered the incidence of acute cerebrovascular disease because of the acute onset, and performed emergency brain MRI. Imaging revealed that although no abnormality was present in the brain parenchyma, edema of the tongue and soft palate was evident on T₂-weighted sagittal imaging. We confirmed the dysarthria was caused by tongue edema due to angioedema. In addition, we diagnosed angiotensinconverting enzyme inhibitor (ACEI)-induced angioedema, because ACEI had been started 2 months earlier as pharmacotherapy for hypertension. Tongue swelling due to angioedema should be considered when examining patients with dysarthria.
Full Text of this Article in Japanese PDF (530K)

(CLINICA NEUROL, 59: 356−359, 2019)
key words: angioedema, tongue edema, dysarthria, angiotensin converting enzyme inhibitor, aged person

(Received: 1-Feb-19)