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PubMed1989

[Left antero-medial thalamic infarction and symptoms of amnesia, aphasia, and dementia].

Three cases of left antero-medial thalamic infarction who showed amnesia, aphasia and dementia were studied comparatively in terms of clinical features and the MRI findings. Case 1 and Case 2, who showed transient amnesia and aphasia respectively, had a single lesion in the left antero-medial thalamus. Case 1 had a lesion in a more ventral part than Case 2, suggesting that Case 1 had a lesion of the bundles into the anterior and dorsomedial thalamic nuclei while Case 2 had a lesion of the ventrolateral thalamic nucleus. On the other hand, Case 3 who showed persistent dementia had multiple lesions in addition to the left antero-medial thalamic infarction. A review of the previous reports and investigations of the present cases suggest that a single ischemic lesion in the left antero-medial thalamus will cause amnesia and/or aphasic symptom while in cases with other multiple lesions it may cause persistent dementia.

Aged↗
PubMedDate not supplied

[A case of crossed aphasia in a right-handed person].

A 17-year-old boy, right-handed, and without a family history of left-handedness is described. Occlusion of the right internal carotid artery caused in him left-sided hemiparesis with aphasia. The cross-aphasia of right-handed individuals is discussed in the light of literature reports.

Adolescent↗
PubMed1989

[Crossed aphasia in a right-handed patient].

A case of crossed aphasia in a right-handed patient provided evidence that cerebral dominance for speech may be located in the right hemisphere. Intravenous injection of amytal in the left carotid artery did not worsen the language disturbances. Comparison of this case with those reported shows that there is not a constant model with only one physiopathological mechanism for all cases of crossed aphasia in right-handed patients.

Aged↗
PubMed1986

Upper extremity sensory feedback therapy in chronic cerebrovascular accident patients with impaired expressive aphasia and auditory comprehension.

Electromyographic (EMG) sensory feedback therapy (SFT) was used in the neuromuscular retraining of the nonfunctional upper extremity in five chronic left cerebrovascular accident (CVA) patients with impaired expressive and auditory comprehension. Speech diagnoses included global, moderate-to-severe Broca, and Wernicke aphasias. These patients had experienced increased despondency associated with previous therapy failures and often had indicated that they wished to have their involved extremity amputated, so that it would no longer be in the way. In this study, specific behavioral training strategies to increase patient involvement were used, including: general relaxation, modified SFT instruction, and home exercises, which were supported by family and/or friends. After an average of 50 therapy sessions, all patients were successfully retrained to use their right upper extremity at the gross-assist level. This resulted in feelings of increased self-esteem to the extent that amputation was no longer requested. It is concluded that EMG SFT can be beneficial in the neuromuscular reeducation of paretic upper extremity muscles of CVA patients with expressive aphasia and (impaired) auditory comprehension.

Aphasia, Broca↗
PubMed1986

Involving relatives in aphasia therapy: an application of language enrichment therapy.

A programme of therapy for aphasia devised in Finland, Language Enrichment Therapy, was tested in an English version, particularly in respect of its co-operative use by speech therapists and the patients' relatives at home. Although a number of changes were recommended, the method was approved of by therapists and relatives. The majority of patients showed improvement, as assessed by the Western Aphasia Battery, over a period of less than three months with a regimen of one hour a week with the therapist supplemented by an average of five hours of help by a relative at home. These results should encourage the development of programmes such as Language Enrichment Therapy as an economic way of enabling speech therapists to use volunteer helpers.

Adult↗
PubMed1985

Creutzfeldt-Jakob disease presenting as progressive aphasia.

The syndrome of slowly progressive aphasia usually has been associated with Pick's disease, Alzheimer's disease, or an isolated focal degenerative disorder of unknown etiology involving the left perisylvian cortex. This report is of a patient with progressive aphasia due to Creutzfeldt-Jakob disease.

Aphasia↗
PubMed1985

[Recovery in aphasia (Part 2): Size and site of lesion].

The digitizer program was used to determine the size of the lesions by tracing them onto standardized matrices which were divided into 3000 point and corresponded to CT slices. Moreover, on the basis of the results of accumulated lesions on 127 cases with various types of aphasia, the highly involved sites were determined as Broca's area, Wernicke's area and conduction area, and the sizes of the lesions in each area were also determined. The correlation between these sizes of the lesions and recovery rates based on the 2 SLTA scores (initial and 3 months later) was studied. The results obtained were as follows: 1) The correlation coefficient between the size of total area and the initial SLTA score was -0.46, significant at p less than 0.01. The negative correlation means that the larger the lesion, the more severe the aphasia. This tendency was seen in all language aspects except "calculation" (i.e. hearing, speaking, reading, writing). A similar, highly significant negative correlation was obtained between the lesion sizes of Broca's area, Wernicke's area, conduction area and initial SLTA scores, but among the various types of aphasics, only the Broca aphasics have a highly significant negative correlation between lesion size and initial SLTA score. 2) The negative correlation between the size of total area and the recovery rate was observed. This tendency was seen especially in the expressive disorders, namely "speaking" and "writing". These findings indicate that the larger the lesions, the less overall recovery will occur in total language deficit and in speaking and writing disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

Aphasia↗
PubMed1985

Treatment of word retrieval deficits in aphasia. A comparison of two therapy methods.

The effects of two therapy methods in the treatment of picture naming problems are compared, using a within-patient design with 12 adult patients with chronic acquired aphasia. We contrast techniques that require the patient to process the meaning corresponding to the picture name (semantic treatment) with those that provide the patients with information about the phonological form of the name (phonological treatment). With each method, patients either had 4 sessions of treatment over one week, or 8 sessions over two weeks. Both methods caused day-by-day improvement that was specific to the actual items treated. Both methods resulted in significant improvement in naming when this was measured one week after the end of treatment, with a small, but significant advantage for the semantic treatment; this is mainly due to improvement that generalizes to untreated items. We conclude that specific and theoretically motivated treatment methods can cause significant improvement in the word retrieval ability of patients with chronic aphasia.

Adult↗
PubMedDate not supplied

[Present day concepts of the cerebral organization of language based on findings in bilingual Oriental patients with crossed aphasia (author's transl)].

Two right-handed bilingual (English and Cantonese) Chinese patients were observed to have crossed aphasia. A preliminary study of a multiracial population with left hemiplegia did not show a higher incidence of aphasia in Chinese subjects. These two extremely rare cases are interesting examples of a particular type of cerebral organization of language.

Aged↗
PubMed1984

On the statistical estimation of speech-organization distributions from aphasia data.

Statistical methods of estimating speech-organization distributions from aphasia data are presented. Under certain assumptions, estimators for the proportions of individuals with unilateral right-hemisphere speech, unilateral left-hemisphere speech and bilateral speech organization are derived, and the large-sample properties of these estimators are presented. It is shown that useful results can be obtained when the most questionable assumption is relaxed. The general methodology is presented in terms of a specific example--the estimation of speech organization distributions of right- and left-handed adults across the three speech types. Under the relaxed assumptions a test of the hypothesis that all left-handers are unilaterally organized is derived. Conservative bounds on the proportions of unilaterally organized (left- and right-hemisphere) and bilaterally organized left-handers are also derived. As an illustration, the results are applied to aphasia-incidence data from the literature. Several uncertainties and inadequacies of the available data are discussed. Although minor modifications of the present methods might be required for other examples, the main ideas would be the same.

Adult↗
PubMed1984

[Aphasia in the Netherlands; extent of the problem].

This article reports on a study of the frequency of aphasia in the Netherlands. Using information obtained from a survey of the literature and data from Dutch Sources, we estimated that in 1979 the incidence must have been about 3500 cases and the prevalence about 5100 cases (the first 2 months of the disease and, with regard to the prevalence the period after 2 years, were left out of consideration). Because of some uncertainties these figures must be considered to be crude estimates of the extent of the aphasia problem in the Netherlands.

Aphasia↗
PubMed1978

Fluent aphasia after closed head injury.

A case of post-traumatic, contre-coup Wernicke's aphasia resulting from left posterior temporal hemorrhagic contusion localized by angiography and CAT scan is reported. Categorization of aphasia is reviewed, emphasizing that a fluent language disorder can be elusive to laymen and non-neurologically oriented physicians.

Adult↗
PubMed1980

[Invalidity and aphasia].

Aphasia may be conceived as a disturbance in one of the functional capacities. Most functional capacities may be 'measured' by performance scales (Katz, Barthel Index, Kenny Numerical Scale). These scales do measure more the 'amount' or 'need' of help than the disturbance itself. So, they measure in fact economic variables instead of medical ones. In 'Regina Pacis' we developed medical scales for the ADL and performance in ambulation. The question is raised whether in certain conditions, they might serve as parameters for the improvement of speech in aphasia. From this starting point these conditions are reviewed and it is thought that a common denominator for both disorders may be found: the ideamotoric disturbance, caused by the CVA. The question is raised if--in those accidents--man himself is fundamentally reduced (stricken) or only deprived from his instruments and tools.

Activities of Daily Living↗
PubMed1983

Mini-object test: a new brief clinical assessment for aphasia-apraxia-agnosia.

Primary degenerative dementia (Alzheimer's disease) is characterized by intellectual decline with impairment of memory, judgment, and abstract thinking. Also common are personality changes and disturbances of higher cortical function such as aphasia, apraxia, and agnosia. Standardized brief cognitive tests are useful for evaluating mental status, which is often limited by short attention span, distractibility, fatigability, mental retardation, illiteracy, and/or confusion. Data from 225 institutionalized patients support the mini-object test (MOT) as a valid, reliable, cost-effective, portable screening procedure for confirming the clinical diagnosis of aphasia-apraxia-agnosia associated with senile dementia of the Alzheimer type. Further studies are needed to demonstrate the diagnostic value of the MOT in other dementing disorders.

Aged↗
PubMed1982

[Neuropsychological study of crossed aphasia with jargon agraphia].

A case of jargon writing following a right vascular cortico-subcortical lesion in the right sylvian territory of a strictly right-handed patient is presented and analyzed. In spontaneous writings the general graphic form of sentences is present (blanks, punctuation) but a great number of neologisms appear. Disorganisation of oral language in this case of crossed aphasia takes the form of a conduction aphasia. The patient is capable of oral spelling and of writing single letters under dictation. If he is asked to spell orally a dictated word while attempting to write it, his writing is much improved. This observation is contrasted with that of an agraphic patient whose writing is limited to concrete nouns. The analysis of the data obtained confirms the existence of different strategies of graphic encoding recently described in various neuropsychological studies: the agraphia of the crossed aphasic patient is related to the lexical form, that of the second patient is related to the phonological form.

Agraphia↗
PubMed1978

[Anatomical and clinical considerations in aphasia: the value of tomodensitometry (author's transl)].

Tomometric tests were carried out in 54 patients with a clinical picture of stabilized or regressive aphasia, some time after the initial episode. The correlation between clinical and topographic findings were satisfactory in 90 p. 100 of the cases. The frequency of lesions extending into several lobes (70 cases) and of multiple lesions is stressed. There is a significant relationship between the severity of the clinical findings during tomometric testing and the volume or multiplicity of the lesions. The progression of the disease after 6 months, as studied in 31 patients, was also related to the volume of the lesion, but was not influenced by the presence of diffuse atrophy, except where the disease was deteriorating. The value of tomometry in the study of aphasia involves 3 factors: precise clinical and lesional correlation, and the effect of the volume of the lesion on its initial severity and progression. In the future, tomometry should enable a correlative symptomatic study of aphasic disorders to be made.

Aphasia↗
PubMedDate not supplied

[Aphasia caused by isolated lesion of the semi-ovale centre: contribution of the measurement of cerebral blood flow].

Sudden onset stroke occurred in a right-handed vietnamese woman speaking, reading and writing french fluently. When first seen in our department, the patient had mild right facial paresis and non fluent atypical aphasia. CT scan and MRI showed a left subcortical infarct in the superficial territory of the middle cerebral artery; only white matter of the semiovale centre was involved. Neurological examination revealed linguistic impairment resembling transcortical motor aphasia, with unusual stuttering, hypophonia, occasional semantic paraphasias and phonological reading and writing abnormalities. Non verbal cognitive function, gestural and buccofacial praxes were normal. Cerebral blood flow study by SPECT was consistent with left sylvian functional deactivation.

Aphasia↗
PubMed1995

Slowly progressive aphasia, a left temporal variant of probable Pick's disease: 15 years of follow-up.

It is known that word-finding difficulties or anomia are the first signs observed in Pick's disease. We report a 15 year follow-up of a woman who at the age of 52 suddenly developed a speech impairment and only 6 years later showed other cognitive disturbances compatible with Pick's disease. This case demonstrates that nonfluent aphasia and agrammatic aphasia may constitute the first signs of this disease, stressing the importance of prolonged follow-up in such cases.

Aphasia↗