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PubMed2006

[Primary progressive aphasia: clinical aspects].

Primary progressive aphasia (PPA), initially described by Mesulam, is a syndrome of progressive deterioration of language, occurring in the presenium. Several classifications have been proposed, but the most useful one distinguishes non fluent and fluent forms of PPA. Both begin by anomia. In non fluent PPA, there is a progressive reduction of language, sometimes with aggramatism and articulatory impairment, but without impairment of comprehension. Fluent PPA is characterized by preserved fluency with severe impairment of single word comprehension. It is frequently confounded with semantic dementia (SD), but some observations can be differentiated from SD. After several years, all patients become mute, and most of them develop dementia, usually of frontal lobe type. The syndrome of PPA is due to neurodegenerative brain pathology affecting mostly the perisylvian regions of the left hemisphere. In most cases, no Alzheimer type pathology was found in the brain, but tauopathy (mainly in non fluent PPA) or motor neuron disease type pathology - tau negative ubiquitin inclusions (mainly in fluent PPA). However, Alzheimer type pathology was found in a substantial number of cases.

Aged↗

PubMed1990

The origins of Freud's concept of object representation ('Objektvorstellung') in his monograph 'On Aphasia': its theoretical and technical importance.

In 'On aphasia' Freud finds it necessary to ask a question: 'In what manner is the body reproduced in the cerebral cortex?' His answer to this question would provide the foundation for the essential concepts of psychoanalytic theory and technique. In this paper I present in detail Freud's conception of the process of representing the body in the cortex. I also attend to the vocabulary he selected to present his ideas. Finally, I describe the consequences of both for his later theorizing. Freud was the first to oppose Meynert's notion that 'a representation is localized in the nerve cell'. Freud suggests that representations are processes without any localization. The process, once formed, has the potential to reappear under proper stimulation, to bring forth, as mnemic images, something psychical (das Psychische). These psychical representations are the sole possessors of the proper stimuli that motivate human beings to talk spontaneously and voluntarily.

Aphasia↗

PubMed1990

[Correlation of thalamic aphasia and cerebral blood flow].

Relations between linguistic deficits and cerebral blood flow (CBF) were studied in 20 cases of thalamic aphasia due to hemorrhage. Language analysis was based on BDAE, verbal intelligence quotient and verbal subtest of the memory quotient (Wechsler). CBF analysis (and of asymmetry index: AI) was done with 133 Xenon by SPECT technique in tomographic slices and in 15 areas of interest, i.e. cortical and deep areas. Relationships were analyzed by multiple correlations procedure and stepwise regression. Significant correlations were observed between linguistic results and AI of cortical but also deep areas (lenticular). Dynamic anomalies (fluency) were correlated with the IA and/or CBF of the frontal cortex. Verbal comprehension, naming and paraphasia were related to the AI of deep structures (insula and lenticular nucleus) and the AI of posterior cortex (temporo-occipital). Several correlations were found significant between results on verbal IQ of the WAIS and IA of the insula and lenticular nucleus.

Aged↗

PubMed1990

[Pharmacotherapy of voice and articulation disorders in aphasia].

The phonation and articulation disorders in a group of aphasics with aphonia/dysarthrophonia could be considerably reduced by the use of medication. The group consisted of 10 apoplectic patients whose resulting aphasia could not be classified because of the vocal impairment. Extrapyramidal motion disorders were proved by laryngoscopy and stroboscopy. A definite improvement of phonation and articulation was observed after L-dopa medication.

Aphasia↗

PubMed1991

[Hemisphere dominance of cortical speech processing and its dynamics in the course of aphasia therapy. A psychophysiologic contribution to the discussion of the neuronal plasticity hypothesis].

Examinations of aphasic patients by using cognitive tasks were based on the hypothesis that semantically evoked potentials correlate to the processing of information in the cortical areas of Broca and Wernicke. Some of the examined right-handed patients with ischemic lesions of the left hemisphere produced characteristic potentials in the right temporal lobe, and not in the dominant left lobe as was expected. These case histories suggest that in these patients speech processing moved into the subdominant hemisphere as a result of compensation after cerebral damage by using the faculty of neuroplasticity. Furthermore an extended classification of aphasias is presented, illustrated by a three-parameter model.

Aged↗

PubMed1991

["Pseudosemantic" aphasia].

It was established that in left hemispheric involvement, the basis of speech disorders are non-understanding the primary speech logical connections in semantic constructions. In right-sided involvement it is caused by disorders of orientation in space, reduction of critical attitude, anosognosia and is according the authors opinion "pseudosemantic" aphasia.

Aphasia↗

PubMed1990

[Conduction aphasia. Neuropsychologic study of a patient].

We report a patient with clinical features consistent with conduction aphasia. The patient had dilated cardiomyopathy, and as a complication, had cerebral infarction one year before neuropsychiatric evaluation. His language was fluid, paraphasic, with a "phonetic approximation behavior" in an attempt to pronounce the adequate word. Comprenssion was normal and repetition difficult, with numerous paraphasias. Number repetition was particularly affected. Reading and writing had the same features as spontaneous language. In association with the language disorder, he had "aphasic" acalculia, but other signs of left parietal involvement were absent. Magnetic resonance images showed a low parietal small chronic ischemic area, which also involved the left infrasilvian region, both in the cortex and in the white matter, presumably in the arcuate bundle. The differential diagnostic difficulties of this condition are discussed from a behavioral standpoint.

Aphasia↗

PubMed1985

[Localization of lesions in aphasia--clinical-CT scan correlations (Part III): Paraphasia and meaningless speech].

According to the result of the visual naming task of 100 realistic pictures, 51 cases were selected from 450 cases with various types of aphasia and divided into two groups, namely, meaningless speech group and paraphasic group. Subsequently, on the basis of the quantitative and qualitative valuation of the spontaneous speech and the naming task, the two groups were subdivided with meaningless speech group being recurring utterance (RU group), undifferentiated jargon (UJ group), asemantic jargon (AJ group) and paraphasic group being literal paraphasia (LP group), verbal paraphasia (VP group). Using a microcomputer, the locus and extent of the lesions, as demonstrated by computed tomography for each group were superimposed onto standardized matrices. The relationship between the focus and the extent of the lesions and the various groups was investigated. RU group (n = 8): The size of the lesions of this group was very large and almost all patients had extensive lesions involving frontal-temporal-parietal lobes. There was marked concentration of the lesions in the area of the insula, lenticular nucleus and the deep structures of the frontal lobe. UJ group (n = 9): In general, the size of the lesions was large and highly involved lesions were located in the lenticular nucleus and operculum as well as the superior and middle temporal gyri and the supramarginal gyrus. Because of the large variability in lesion patterns, it has proved to have little localizing value. AJ group (n = 11): The size of the lesions was significantly smaller than any other group. At least 80% of the patients had the superior temporal lesions involving Wernick's area and subcortical lesions of the supramarginal gyrus. LP group (n = 8): The lesions were relatively large in size. While there was some concentration of the lesions in the area of the lenticular nucleus, posterior parts of the insula and anterior temporal gyrus, it was difficult to localize in a definite region. VP group (n = 15): The lesions of this group were a little smaller and located slightly deeper than those of the LP group. The finding has proved to have little localizing value.

Adult↗

PubMed1986

[A form of acquired childhood aphasia: Landau-Kleffner syndrome].

The Landau-Kleffner syndrome is a childhood disorder associating a loss of previous acquired speech with seizures and bilateral abnormalities on the EEG. The precise aetiology of this syndrome is unknown. Epilepsy is easily regulated by anticonvulsants. However, the aphasia is a more persistent defect and recovery is incomplete in 2/3 of the cases despite intensive speech therapy. A typical case is described in detail. Of five additional cases the most relevant data are presented.

Anticonvulsants↗

PubMed1987

[A Japanese case of crossed aphasia in a right-handed patient. Apropos of kana and kanji].

The Japanese orthography has some unique characteristics. Two types of Japanese characters, kana (phonetic symbols) and kanji (semantic and phonetic symbols), are used in combination. Although kana has simple forms and a limited number of characters, and kanji has complex forms and an infinite number of characters, Japanese aphasic patients often have trouble using kana characters properly. In the present case of crossed aphasia of a right-handed Japanese man due to a large hypertensive intracerebral hematoma in the right side, we also observed the impairment in kana processing. He could neither speak nor read aloud, but on multiple choice examinations, he could point to pronounced kanji letters. Although he could point to pronounced kana words, he could not point to kana letters. We will review some tachistoscopic studies of recognition and comprehension of the lateralized visual informations of kana and kanji for normal Japanese and for Japanese patients with disconnection syndrome. And we will discuss the right (minor) hemispheric ability to recognize kanji letters and kana words, and we will also talk about the restricted capacity for transcallosal transference of the visual language informations.

Aphasia↗

PubMed1987

[Persistent aphasia as the most conspicuous phenomenon of extensive disconnection of the cortical speech region].

An unusual case is analysed in which global aphasia has obtained for ten years, with complete speech inability and loss of the acoustic understanding of words, due to extensive cortical lesions in both halves of the cerebrum. After two years of observation of the case and frequent neuropsychological examination, the cause is seen as being in the almost complete elimination of the cortical region of speech. The manifestation occurred when the patient was nine years old, and intensive efforts at pedagogic rehabilitation, on which a separate report will be made, were begun eight years later.

Adolescent↗

PubMed1987

[Comparative study of neurolinguistic variables in Alzheimer patients, traumatic aphasias and Korsakoff psychoses and normal control probands].

There are few studies of the breakdown of language in specific dementias and there is some dispute that language pathology in brain failure is comparable to that of focal lesions. It is recognized that while aphasic language is a disturbance of receptive and propositional speech, disturbances of "InnerLanguage" disrupt the planning and regulatory basis of behavior. This paper presents a comparison of three pathological groups to match normal controls and suggest that in its initial stages reduced cognitive performances in Alzheimers type Dementia and Korsakow Psychosis on non verbal measures maybe a further of the regulatory role of inner speech comparison with traumatic Aphasia which more clearly exists on a deficit of verbal comprehension and expression.

Alcohol Amnestic Disorder↗

PubMed1987

[Crossed aphasia in a child].

Aphasia due to a cortical--subcortical infarct occurred in a right-handed, five year-old boy. Twelve years later, language disturbances were still present.

Aphasia↗

PubMed1987

Acute aphasia and loss of vision with desferrioxamine overdose.

Reversible aphasia, loss of vision, bradycardia, and mild hypotension occurred in a 6-year-old girl with aplastic anemia and transfusion-related iron overload after inadvertent increase of her intravenous desferrioxamine drip. Signs and symptoms were reversed promptly by intravenous fluids, suggesting that desferrioxamine, when given as a sudden intravenous bolus, may upset vasoregulation. Three possible mechanisms are discussed that could explain this phenomenon. High-dose intravenous desferrioxamine ought to be given by pump infusion only, in order to avoid accidental overdose.

Anemia, Aplastic↗

PubMedDate not supplied

[Sex-dependent therapeutic success in therapy of aphasia in the elderly].

In a retrospective analysis of elderly patients with aphasia who had had a stroke, the success of therapy was sex-related. In the women treated, significantly better results could be achieved despite the fact that on average the women were older, lived in worse social conditions and had a shorter course of therapy than the men. The main reason for our findings may be sex-related role behaviour.

Aged↗

PubMed1989

[The Landau-Kleffner syndrome: a special form of acquired childhood aphasia].

The syndrome of "acuqired aphasia with convulsive disorder" occurs in children between 3 and 7 years of age and is characterized by a language disorder with heterogeneous epileptic manifestations. The pathogenesis is unknown. The course can show marked fluctuations. Our study of 6 children shows that the outcome can range from extremely unfavorable to complete recovery. The variables that possibly influence the course are discussed.

Aphasia↗

PubMed1987

Acquired aphasia of childhood with epilepsy: the Landau-Kleffner syndrome.

The Landau-Kleffner syndrome is an unusual childhood disorder characterised by an acquired aphasia and a paroxysmal electroencephalographic abnormality with spike and spike and wave discharges which are mostly multifocal and unstable in their course of evolution. Two accessory symptoms are frequently observed: psychomotor or behavioural disturbances and epilepsy. Epileptic seizures are most often generalised convulsive or partial motor and invariably disappear before the age of 15 years. A 20 year old woman is described who has been followed since the rarely observed onset of the Landau-Kleffner syndrome at the age of 3 years. At 4 years of age she was totally unable to communicate through speech and her EEG showed almost continuous bitemporal spike and spike and wave discharges. Maximum doses of diazepam, phenytoin, carbamazepine and sulthiame were used without effect. From the age of 14 years her ability to communicate through spoken and written language has improved and her EEG now shows no epileptiform activity.

Adult↗

PubMedDate not supplied

Landau-Kleffner syndrome--epileptic aphasia in children--possible role of toxoplasma gondii infection.

The association of unusual types of aphasia and epilepsy (Landau-Kleffner syndrome) has been described in three children. The children were 5 to 11 years of age and all have EEG abnormalities. Speech disorders appeared after epileptic seizures. No organic causes of the disease have been found in axial computed tomography. In all described cases the increased titer of IgG antibodies against Toxoplasma gondii has been observed. The authors suggest that the Toxoplasma gondii infection should be taken into account as a possible cause of Landau-Kleffner syndrome.

Antibodies, Protozoan↗