[The acute headache from the neurological viewpoint].
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Biomedical subjects
Publications and source records attributed to K Poeck.
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Broca's aphasia is characterized by disorders on the phonemic, syntactic and lexical level of linguistic description. It is not only the patient's speech which is impaired; abilities to comprehend, read and write are likewise impaired. Articulatory disorders (dysarthria) which are due to an impaired innervation of the phonatory and articulatory musculature may exist. However these disorders do not account for all the linguistic deficits found in cases of Broca's aphasia. The characteristic feature enabling a differential diagnosis of Broca's aphasia is agrammatism.
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Global aphasia is described as a unitary syndrome which is characterized by a severe impairment of all linguistic capabilities. Speech production is extremely limited and consists of stereotyped phrases, recurring utterances or a few isolated words which are usually neologistically distorted. The patients are unable to express their thoughts in a situationally adequate manner. Language comprehension is restricted to simple questions and commands. A clinical description of the syndrome is given and the neurolinguistic structure of the disorders is discussed.
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The most important neurologic diseases which may start during pregnancy are described. On the basis of clinical, easily discovered, signs the essential differential diagnosis and specific diagnostic techniques (electromyography, electroneurography, angiography, computotumography) and their indications are outlined. In some detail prognosis and indications for common diseases (epilepsy, M.S.) are discussed. Treatment of those diseases is especially considered in which emergency drug therapy may be needed.
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Despite the variability of its behavioral manifestations Wernicke's aphasia is considered to be a unitary syndrome. According to the criteria of intelligibility, phonemic and semantic paraphasias in spontaneous speech, 4 forms of Wernicke's aphasia are differentiated: 1) with predominantly semantic paraphasias, 2) with semantic jargon, 3) with predominantly phonemic paraphasias and 4) with phonemic jargon. A severe deficit in language understanding is common to all 4 forms. In addition to phonemic and semantic paraphasias paragrammatism is an outstanding feature of the language production in Wernicke's aphasia. After a survey of views about the localization of the lesion and of earlier descriptive models a neurolinguistic explantation of the characteristic symptoms of Wernicke's aphasia is suggested.
We have examined the severity and quality of aphasic misnaming in colour naming tasks as compared to errors of patients with right-sided brain damage and to patients with posterior disconnexion syndrome. The investigation is based on 80 aphasic patients, 20 patients with right-sided brain damage and 80 normal control subjects. Differences in the performance for colour and object naming are discussed. The main results were: 1. The subtypes of aphasia did not differ quantitatively in both types of performance. All aphasics made significantly more errors on colour naming than on object naming tasks. This difference, however, was numerically too small to have practical value. 2. Unlike in the corresponding understanding tasks, both types of naming tasks differentiated between aphasic and non-aphasic patients, the aphasic group performing poorer. 3. The four subtypes of aphasia had similar error scores in the 10 colour tasks. We observed certain regularities in the type of paraphasic misnaming for the total group of aphasics. The subgroup of amnesic aphasia was characterized by a strategy of modifying the colour terms similar to the description of use encountered in the language behavior of these patients. 4. Patients with posterior disconnexion syndrome in general make 7 errors out of 10 tasks in colour naming, in contrast to 2 errors out of 10 tasks in object naming. For aphasic patients the relation is 3.5 to 2.5 errors.