Session Information
Session Title: AA 2021 Virtual Posters - Neurological Rehabilitation
Session Time: None. Available on demand.
Disclosures: Samir A. Khan, DO: No financial relationships or conflicts of interest
Case Diagnosis: Expressive aphasia secondary to seizure after subdural hematoma
Case Description: 76-year-old male with no pertinent medical history was admitted to inpatient rehabilitation (IPR) with expressive greater than receptive aphasia following seizure-like activity after sustaining a left subdural hematoma secondary to a ground-level fall. He was prescribed donepezil in addition to conventional therapies. At the time of discharge two weeks later, his aphasia was considerably improved.
Setting: Inpatient rehabilitation hospitalAssessment/
Results: Upon presentation to IPR, vital signs were stable. His neuropsychological exam was notable for dense expressive aphasia confirmed by a total score of 78/100 on the Mississippi Aphasia Screening Test (MAST), with 32/50 on the expressive portion and 46/50 on the receptive portion. He was started on oral donepezil 5mg daily which he tolerated well for three days; it was then increased to 10mg daily for a total of 10 days. He continued with conventional therapies including physical, occupational, and speech. He continued making significantly functional gains. Immediately prior to discharge his MAST score was 100/100.
Discussion: Donepezil is a reversible cholinesterase inhibitor traditionally prescribed in the treatment of Alzheimer’s dementia as a means to attenuate cognitive decline, for which it is approved by the US Food and Drug Administration (FDA). It has also been shown to improve poststroke aphasia and has recently gained popularity in cognitive recovery following brain injury. In this case it was utilized “off label” as an adjunct to the typical therapies received at IPR to specifically target the patient’s expressive aphasia.
Conclusion: Oral donepezil may positively augment the rehabilitation of expressive aphasia resulting as a sequela of traumatic brain injury.
Level of Evidence: Level V
To cite this abstract in AMA style:
Khan SA, Plummer CJ, Abramson N, Cash C. Donepezil as an Augmentation to the Rehabilitation of Expressive Aphasia due to Brain Injury [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/donepezil-as-an-augmentation-to-the-rehabilitation-of-expressive-aphasia-due-to-brain-injury/. Accessed May 11, 2025.« Back to AAPM&R Annual Assembly 2021
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/donepezil-as-an-augmentation-to-the-rehabilitation-of-expressive-aphasia-due-to-brain-injury/