Aphasia As the Initial Presentation of Acute Otomastoiditis in an Elderly Male

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2021 May 10

PMID 33968507

Authors

Sherif T Abuserewa

Mohamed Faris

Thaddeus Golden

Affiliations

Soon will be listed here.

Abstract

Acute otomastoiditis is a potentially life-threatening condition. It is relatively uncommon in elderly patients and is usually seen as a complication of acute otitis media. Limited studies are available on this uncommon disease in the elderly, and thus the clinical course of the disease is not fully understood. Proper use of antibiotics for acute otitis media has markedly decreased the incidence of acute otomastoiditis. We describe a case of a 76-year-old male with acute otomastoiditis complicated by cerebellopontine angle epidural abscess who presented with a chief complaint of sudden onset of global aphasia, which is an unusual presentation for acute otomastoiditis. The patient eventually required medical and surgical intervention. To the best of our knowledge, acute otomastoiditis presenting with sudden onset of global aphasia has not been previously described in the literature. This case illustrates how multidisciplinary team involvement is vital in the management of these uncommon cases.

Citing Articles

Clinical and Pathological Characteristics of Chronic Otomastoiditis: A Retrospective Analysis of Risk Factors, Outcomes, and Antibiotic Resistance Patterns.

Popescu C, Popescu A, Varut R, Popescu M, Niculescu C, Singer C Healthcare (Basel). 2025; 12(24.

PMID: 39765945 PMC: 11728319. DOI: 10.3390/healthcare12242518.

References

Sonavane A, Baradkar V, Kumar S . Enterococcal Cerebellopontine Angle Abscess in a 12-year-old Female. J Glob Infect Dis. 2010; 2(1):67-9. PMC: 2840972. DOI: 10.4103/0974-777X.59255. View

Hanlon R, Lux W, Dromerick A . Global aphasia without hemiparesis: language profiles and lesion distribution. J Neurol Neurosurg Psychiatry. 1999; 66(3):365-9. PMC: 1736239. DOI: 10.1136/jnnp.66.3.365. View

Blank S, Scott S, Murphy K, Warburton E, Wise R . Speech production: Wernicke, Broca and beyond. Brain. 2002; 125(Pt 8):1829-38. DOI: 10.1093/brain/awf191. View

Hillis A . Aphasia: progress in the last quarter of a century. Neurology. 2007; 69(2):200-13. DOI: 10.1212/01.wnl.0000265600.69385.6f. View

Isaacs K, Barr W, Nelson P, Devinsky O . Degree of handedness and cerebral dominance. Neurology. 2006; 66(12):1855-8. DOI: 10.1212/01.wnl.0000219623.28769.74. View

van den Aardweg M, Rovers M, de Ru J, Albers F, Schilder A . A systematic review of diagnostic criteria for acute mastoiditis in children. Otol Neurotol. 2008; 29(6):751-7. DOI: 10.1097/MAO.0b013e31817f736b. View

Lu C, Chang W, Lin Y, Tsai N, Liliang P, Su T . Bacterial brain abscess: microbiological features, epidemiological trends and therapeutic outcomes. QJM. 2002; 95(8):501-9. DOI: 10.1093/qjmed/95.8.501. View

Kurien M, Job A, Mathew J, Chandy M . Otogenic intracranial abscess: concurrent craniotomy and mastoidectomy--changing trends in a developing country. Arch Otolaryngol Head Neck Surg. 1998; 124(12):1353-6. DOI: 10.1001/archotol.124.12.1353. View

Szaflarski J, Binder J, Possing E, McKiernan K, Ward B, Hammeke T . Language lateralization in left-handed and ambidextrous people: fMRI data. Neurology. 2002; 59(2):238-44. DOI: 10.1212/wnl.59.2.238. View

10.

Mesulam M . Large-scale neurocognitive networks and distributed processing for attention, language, and memory. Ann Neurol. 1990; 28(5):597-613. DOI: 10.1002/ana.410280502. View

11.

Yang Z, Zhao X, Wang C, Chen H, Zhang Y . Neuroanatomic correlation of the post-stroke aphasias studied with imaging. Neurol Res. 2008; 30(4):356-60. DOI: 10.1179/174313208X300332. View

12.

Go C, Bernstein J, de Jong A, Sulek M, Friedman E . Intracranial complications of acute mastoiditis. Int J Pediatr Otorhinolaryngol. 2000; 52(2):143-8. DOI: 10.1016/s0165-5876(00)00283-4. View

13.

Chen R, Young G . Metabolic encephalopathies. Baillieres Clin Neurol. 1996; 5(3):577-98. View

14.

Penido N, Borin A, Iha L, Suguri V, Onishi E, Fukuda Y . Intracranial complications of otitis media: 15 years of experience in 33 patients. Otolaryngol Head Neck Surg. 2005; 132(1):37-42. DOI: 10.1016/j.otohns.2004.08.007. View

15.

Pellegrini S, Gonzalez Macchi M, Sommerfleck P, Bernaldez P . Intratemporal complications from acute otitis media in children: 17 cases in two years. Acta Otorrinolaringol Esp. 2011; 63(1):21-5. DOI: 10.1016/j.otorri.2011.06.007. View

16.

Dronkers N, Wilkins D, Van Valin Jr R, Redfern B, Jaeger J . Lesion analysis of the brain areas involved in language comprehension. Cognition. 2004; 92(1-2):145-77. DOI: 10.1016/j.cognition.2003.11.002. View

17.

Trimis G, Mostrou G, Lourida A, Prodromou F, Syriopoulou V, Theodoridou M . Petrositis and cerebellar abscess complicating chronic otitis media. J Paediatr Child Health. 2003; 39(8):635-6. DOI: 10.1046/j.1440-1754.2003.00251.x. View

18.

Mohanty S, Dhawan B, Kapil A, Das B, Pandey P, Gupta A . Brain abscess due to Enterococcus avium. Am J Med Sci. 2005; 329(3):161-2. DOI: 10.1097/00000441-200503000-00011. View

19.

Dronkers N . A new brain region for coordinating speech articulation. Nature. 1996; 384(6605):159-61. DOI: 10.1038/384159a0. View