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PubMed1992

[Visual agnosia evolving to optic aphasia--a case study].

The underlying mechanism of visual agnosia and optic aphasia has not been fully elucidated, although a number of hypotheses have been proposed. Besides, the difference between these two conditions has been a matter of debate. We report here the result of neuropsychological evaluation in a case of associative visual agnosia evolving to optic aphasia. A 64-year-old right-handed patient was found to be disoriented and confused after undergoing the operation of gastrectomy. CT scan revealed a large infarction in the territory of left posterior cerebral artery. Since 3 weeks after onset, neuropsychological investigations were carried out during 5 months. He was alert and co-operative. Right homonymous hemianopia with macular sparing was noted, but his visual acuity was normal. There was neither a global deterioration of intellectual capacities nor aphasia. Most striking finding was his difficulty in identifying common objects and colours along with a profound alexia. Prosopagnosia was absent. Visual naming both for objects and line drawings was severely impaired. He was unable to describe or demonstrate the use of the objects which could not be named. Pointing to objects named by the examiner was also severely impaired. Although tactile naming was also impaired, both of auditory naming for environmental sounds and naming objects in response to verbal descriptions were preserved. While he was not able to copy the objects skillfully, matching of identical objects and matching objects to line drawings were normal. Clumsiness of coping was thought to be due to his constructional apraxia and visuomotor ataxia. Therefore, his deficit in visual domain was considered to be associative visual agnosia.(ABSTRACT TRUNCATED AT 250 WORDS)

Agnosia↗
PubMed1992

Persistent interictal aphasia after repeated partial seizures: a case report.

We reported a case of persistent interictal aphasia after repeated partial seizures. This 64-year-old man, left-handed and literate, developed repeated right facial twitching associated with head turning to the right or transient loss of awareness since October 30 1991. Persistent aphasia between seizures occurred from November 4. An electroencephalogram (EEG) on November 6 showed an epileptic focus over the left frontal area. Tc-99m HMPAO brain single photon emission computed tomography (SPECT) performed one and half and hour after an attack on November 7 showed focal hyperperfusion over the left frontal area. The aphasia recovered on November 7 after the seizures had been stopped. Follow-up EEG and Tc-99m HMPAO brain SPECT done on November 11 and November 14 respectively were normal.

Aphasia↗
PubMedDate not supplied

[Diagnosis and therapy of geriatric aphasia patients following cerebrovascular stroke].

Aphasia is common in elderly patients with stroke. This paper presents some results of aphasia therapy within the activation phase (acute aphasia) and the syndrome-specific learning phase (until the 24th week of treatment). A phase-specific therapeutic concept was developed to connect stimulation and cirumvention method and compensatory techniques. The results attest to the success early after stroke regarding development of speech pathology logopedic diagnosis and therapy.

Aged↗
PubMed1992

Preliminary findings in a study of age, linguistic evolution and quality of life in recovery from aphasia.

Age has been reported as both a decisive and weak variable in recovery from aphasia. A middle aged group of aphasic subjects (50-64) are compared with an older group (65-80) on linguistic task performance, functional communication and quality of life measures administered at 3, 6, 9, and 12 months post stroke. Preliminary findings do not suggest any age based recovery discrepancies for middle aged versus older aphasic subjects on these measures in the first post stroke year. An hierarchical pattern of severity across aphasia type emerged, with fluent aphasic subjects being the least and global aphasia subjects the most impaired both at the beginning and end of the first post stroke year. There appear to be differences in the schedule of improvement on different measures, which remain to be confirmed in the final analysis of the data.

Activities of Daily Living↗
PubMed1992

[Transient total motor aphasia. A complication of an axillary brachial plexus block].

Hypo- and hypertension, arrhythmias, bradycardia extending to cardiac arrest with circulatory failure, pneumothorax, allergic reactions with or without anaphylactic shock, production of methaemoglobin, vomiting, vertigo, disorientation, acoustic and visual disorders, tinnitus, slurred speech, muscle contractions, unconsciousness, and epileptic seizures are well-known complications associated with local anaesthetics. We have observed an additional central nervous system complication: a case of transient, total motor aphasia (Broca aphasia) in a 50-year-old patient after axillary blockade of the brachial plexus. Possible causes such as type and dosage of local anaesthetic or a transient ischaemic attack in the area of the prerolandic artery are discussed and related to the literature. Ultimately, however, it is still not apparent why this complication could appear although there was no overdosage intravascular injection, or abnormality of the pulse or blood pressure, and why its manifestation was limited to a motor aphasia.

Aphasia, Broca↗
PubMed2005

[Jargonagraphia in a left-handed aphasia due to a left hemisphere lesion].

We report a case who developed jargonagraphia, severe aphasia and unilateral spatial neglect due to cerebral infarction in the left hemisphere. The patient was a 57 year-old left-handed woman. She suddenly developed hemiplegia on the right side and aphasia, and was admitted to our hospital. Neuropsychological examination showed non-fluent spontaneous speech. Repetition, reading and auditory comprehension were impaired. Writing was severely impaired and she showed paragraphia without meaning (jargonagraphia). Right unilateral spatial neglect and buccofacial apraxia were noted, but neither ideomotor nor ideational apraxia was observed. The mechanisms of jargonagraphia remain unknown. The localization of language function in this patient is not a mirror image of same function in dextral aphasia. Her condition was considered that free-running on motor engrams of characters stored in the right hemisphere caused jargonagraphia.

Agraphia↗
PubMed2005

[Clinical observation on acupuncture for treatment of aphasia due to ischemic stroke at the early stage].

OBJECTIVE: To observe therapeutic effect of acupuncture on aphasia due to ischemic stroke at the early stage. METHODS: Seventy cases of aphasia due to ischemic stroke at the early stage were randomly divided into an acupuncture group and a control group. The control group were treated with standard medication and rehabilitation direction, and the acupuncture group with the standard medication and rehabilitation direction plus acupuncture. Evaluation and comparison were carried out before treatment and 15 and 30 days after treatment with the western aphasia battery (WAB) AQ indexes. RESULTS: The WAB AQ index evaluation 15 days and 30 days after treatment in the acupuncture group were better than those in the control group (P < 0.05 or P < 0.001). CONCLUSION: Acupuncture has synergistic action with the standard medication and rehabilitation direction.

Acupuncture Therapy↗
PubMed1990

Acquired childhood aphasia with convulsive disorder (Landau-Kleffner syndrome). A case report.

The Landau-Kleffner syndrome is a rare form of acquired childhood aphasia associated with convulsive disorder. These children are typically misdiagnosed. A 15-year-old girl whose aphasia was not diagnosed until the age of 13 is described. Pitfalls in diagnosis are discussed, particularly with regard to interpretation of the results of audiometric testing. Attention is drawn to the existence of this rare form of aphasia and to the lack of appropriate educational facilities for aphasic children in general.

Adolescent↗
PubMed1990

[Neurophysiological mechanisms of aphasia in epilepsy].

The EEG, visual and auditory evoked potentials were examined in 4 patients with aphasia-epilepsy. All the examined manifested focal discharges of high-amplitude acute waves, peaks and peak-wave complexes in the temporal leads on the left or on the side of assumed dominance according to speech. The same leads showed transformation of auditory and visual evoked potentials to peak-wave complexes. The intensity of epileptic focal discharges on the EEG correlated with the gravity of aphasia, whereas effective treatment bringing about suppression of epileptic discharges in the temporal parts favoured speech recovery. Obviously, speech disorders in patients with aphasia-epilepsy are caused by neurodynamic disorders of information transfer and processing in the speech zones of the temporal lobe.

Aphasia↗
PubMed2006

Quality of life and aphasia. Multicentric standardization of a questionnaire.

AIM: It is important to assess aphasics' quality of life in order to plan a rehabilitation treatment. To date such a tool is still missing for Italian patients. This paper reports normative data of the Italian version of SAQOL-39, a British questionnaire aimed to assess aphasics' quality of life. It consists of 39 items, divided into 4 subdomains (Physical, Communication, Psychosocial and Energy). METHODS: Forty-two patients coming from 3 different Speech Therapy Services were enrolled. All patients completed speech therapy before examination. They were submitted to the Italian SAQOL-39 and 2 screening tests for aphasia: 1) Communication Assessment Scale according Goodglass and Kaplan; 2) Franchay Aphasia Screening Test (FAST). A receptive FAST score of 7 out of 15 was used as a cut-off score for SAQOL-39 administration. RESULTS: The Italian SAQOL-39 showed good internal consistency (full scale Cronbach's alpha 0.939). Cronbach's alpha for every subdomains ranged from 0.950 (Communication) to 0.720 (Energy). Fluent aphasics gave significantly higher scores than nonfluent ones on full scale, and all out of Energy subdomains. Furthermore gravity of aphasia correlated with both full scale and Communication subdomain scores. CONCLUSIONS: In authors' opinion, the Italian SAQOL-39 shares many psychometric features with the English one. This questionnaire seems to be suitable for clinical practice.

Aged↗
PubMed1991

Diagnostic and management considerations of acquired epileptic aphasia or Landau-Kleffner syndrome.

A small number of children have been identified as having an interruption in their communicative progress known as Landau-Kleffner syndrome, acquired epileptic aphasia, or aphasia with convulsive disorder. Although presenting symptoms have differed among the cases reported, a progressive or acute language loss and inattentiveness to auditory stimuli are the most common manifestations. Typically, these children begin developing language normally and then, for no apparent reason, language progress is disrupted. This disruption is accompanied by the onset of seizure activity and/or abnormal electroencephalographic (EEG) findings. While this disorder appears to be relatively uncommon, its frequency is questionable due to its unfamiliarity among the audiology and otology communities and, thus, it is subject to the likelihood of misdiagnosis. A case of acquired epileptic aphasia is described herein. A team diagnostic and management approach, which can include audiology, otology, psychology, neurology, and speech-language pathology is recommended for such cases. Earlier identification of this debilitating disorder is needed in order to secure appropriate intervention and reestablish communication systems for these children.

Aphasia↗
PubMed1991

Aphasia in polyglots: report of two cases and analysis of the literature.

Two cases of aphasia in polyglot patients who experienced different symptoms in each of the languages they knew are reported. The authors discuss the problem and analyze the available literature in an attempt to formulate a pathogenetic hypothesis of the different involvement of the known idioms sometimes observed in aphasic polyglots. In particular, when time has elapsed between the learning of the mother tongue and other languages, and all the known languages are, consequently, functionally independent, it is possible that the two or more known idioms have distinct anatomical representations, probably localized separately in the two hemispheres. This could explain why, in some polyglots, aphasia affects one of the known languages preferentially. In subjects in whom the different known idioms were learned during early childhood, the anatomical representation of the languages is similar, which explains why, in this kind of polyglot, all the known languages can be equally affected by cerebral damage that causes aphasia.

Adult↗
PubMed1991

[Different clinical types of degenerative aphasia].

The authors report 3 cases of slowly progressive aphasia with different language disturbances: anomia, pure word deafness and Broca's aphasia. All patients were independent in daily life activities. Insight, judgement and overall behaviour were intact. There was no major disturbance of other cognitive functions, but psychometric tests showed mild deficits suggesting widespread involvement. CT scans and magnetic resonance imaging showed focal dilatation of the left sylvian fissure. A positron emission tomographic study showed left perisylvian hypometabolism. A review of the literature yielded an increasing number of cases of this degenerative syndrome affecting dominant hemisphere language areas. Our cases confirm the clinical heterogeneity of degenerative aphasia. Postmortem neuropathological examinations are rare and many causes are found: Pick's disease, Alzheimer's disease or aspecific gliosis.

Aged↗
PubMed1989

[Various approaches to restoration of visual memory in aphasia].

The techniques of restitution of visual memory in aphasia patients are described. A specially designed testing procedure proved their efficiency. Analyzed is the dependence of visual memory restitution on the form and severity of aphasia, age and educational level of the patients. Verbal mediation of the memorized visual information is uneffective in aphasia. The results are treated in terms of psychological and neuropsychological concepts of memory.

Adult↗
PubMed1985

[Degenerative aphasia].

A woman had difficulties in word finding since age 59, this became a Broca's aphasia then a global aphasia. The only possible expression was written and agrammatic with many semantic errors. Calculation was preserved as well as constructional praxis. Ideomotor praxis was slightly impaired. Visual recognition and somatagnosia were normal. Neurological examination showed neither motor nor sensitive impairment. Visual fields were normal. CT scan at onset was normal. Later a slight cortical atrophy appeared predominating on the sylvian fissures, slightly more severe on the left side. Reviewing the literature the authors draw attention on the possible occurrence of an evolutive aphasia being the first evidence of a dementia. The impairment of the other cognitive functions would only appear after several years.

Aphasia↗
PubMed1979

Common dimensions of visual and auditory agnosia and an explanation of the auditory recognition deficit in aphasia.

An experimental analysis of auditory recognition disturbances was performed; 81 patients with localized cerebral lesions were examined with a recognition test for meaningful sounds and with a nonverbal intelligence test (Block Design). Sensory stimulation was 5 or 15 sec for each sound. Nonverbal intelligence accounted for a considerable and significant amount of variance in recognition performance. The aphasic group was more impaired in auditory recognition than were both the other groups, i.e., patients with right or left hemispheric lesions without aphasia. The auditory recognition disturbance in the aphasic group depended to a significant extent on stimulus duration, which means a slowing down of the recognition process in aphasia. The analogies to studies on visual agnosia are striking. In both modalities, recognition depends on intellectual functioning, sensory disturbances or reduced sensory input, and the presence of aphasia.

Adult↗
PubMed1977

[In the boundaries of aphasia].

The anatomical boundaries of those structures whose lesion leads to the disturbances of language are indistintic and largely exceed the classical "areas of language", including subcortical structures as the thalamus and the non-dominant hemisphere. It is equally indistinct the possibility of definition of aphasic disturbances. On one hand aphasia can be seen within the realm of decodification, as a failure of a mental rather than of a verbal process, close to dementia, while among the codification mechanisms motor aphasia can appear a syndrome of phonetic desintegration with component of apraxic, dystonic and paretic nature. Esquizophasia and agrammatism are two examples of those peculiar disturbances of language. The correlation between disturbances of language and of intelligence is another frontier of aphasies where a causal relationship appears to be well established. Aphasias, interpreted in the beginnings as anatomically localized well defined disturbances of function, are now seen both anatomically and functionally, as a process with indistinct and mixed boundarie related to other equally illimited and indistinct functions.

Aphasia↗
PubMed1984

[Aphasia caused by left paramedian thalamic infarction. Anatomo-clinical case].

A 67 year-old right-handed man presented with an aphasia of acute onset associated to paralysis of vertical eye movements, mild cerebellar right dysmetria and right hemiparesis without hemianopia. CT scan showed two low density areas in the left thalamus and left occipital lobe. Neuropsychological examination revealed a non fluent aphasia with normal repetition, semantic paraphasias, perseverations and good comprehension of verbal and written commands. There was no alexia. Writing was impaired only by motor disturbances. Three weeks after the onset, tetraparesis and impairment of consciousness followed by a locked in syndrome supervened. Death occurred four months after onset. Neuropathological examination showed a left paramedian thalamic infarct involving the ventrolateral, dorso-medial and intralaminar nuclei, sparing the pulvinar. There was an occipital infarct sparing the calcarine scissura and multiple infarctions in the pons and the cerebellum. Broca's and Wernicke's areas were spared. We suggest that the involvement of medial nuclei could be partly responsible of language disturbances in thalamic aphasia.

Aged↗