A 71-year-old right handed man showed insidious and progressive declin
e of language skills, in contrast with relatively preserved performanc
e on tests and ability to be independent in daily living. Three years
later, he developed swallowing difficulties. MRI scans showed widening
of the left sylvian fissure. A SPECT scan demonstrated focal hypometa
bolism restricted to the left temporal lobe. Videofluoroesophagography
revealed marked hesitation of oral preparation and oral phases, while
the reflex phases were unimpaired. The patient failed to perform oral
tasks on command and imitation without motor and sensory deficit. We
believe that his swallowing difficulty was due to oral apraxia. This c
ase adds to the heterogeneity of patients with primary progressive aph
asia.