1/52. Foreign accent-like syndrome during psychotic exacerbations.OBJECTIVE: The goal of this investigation was to describe the neurologic and psychiatric findings in a patient with foreign accent-like syndrome occurring during episodes of psychotic exacerbation. BACKGROUND: Foreign accent syndrome has been reported in several patients with disorders such as cerebral infarction, cerebral hemorrhage, and head trauma but not in a patient whose primary problem was psychosis. Most patients with this syndrome exhibit some degree of aphasia, and some are dysarthric. METHOD: A schizophrenic patient with foreign accent-like syndrome occurring during a psychotic exacerbation was evaluated by examination and interview, language testing, magnetic resonance imaging, electroencephalography, and other investigative methods. RESULTS: The patient exhibited a prominent British accent, which persisted throughout the duration of his psychotic exacerbation and resolved with improvement of his psychosis. magnetic resonance imaging revealed no lesions, and no abnormality of language or articulation was present. A single-photon emission computed tomography scan could not be obtained. CONCLUSIONS: This represents the first reported case of a patient with foreign accent-like syndrome during psychotic exacerbations.- - - - - - - - - - ranking = 1keywords = aphasia (Clic here for more details about this article) |
2/52. Evaluation and outcome of aphasia in patients with severe closed head trauma.In this study long-term observation of 12 patients with aphasia secondary to severe closed head trauma took place. The most frequent symptoms were amnestic aphasia and verbal paraphasia. Only one patient with a constant slow wave EEG focus in the dominant hemisphere had severe receptive symptoms. In all other patients the aphasia recovered rather well, though not totally, but the presence and degree of concomitant neuropsychological disorders were most important for the final outcome.- - - - - - - - - - ranking = 8keywords = aphasia (Clic here for more details about this article) |
3/52. rehabilitation outcome in a patient awakened from prolonged coma.BACKGROUND: This article describes the rehabilitation of a patient recovering from a prolonged coma (defined as lasting longer than 4 weeks). The case is noteworthy because it exemplifies the possibilities and difficulties entailed in treating these patients, who are often regarded as too severely impaired to justify intensive rehabilitation efforts. CASE REPORT: The patient is a 28-year old Polish male, unmarried, who suffered serious closed head injuries in an automobile accident in April of 1999. He was in a comatose state for more than two months, with a GCS score of 5. When admitted for rehabilitation he was bedridden, with global aphasia, agraphia, limb apraxia, and executive dysfunction. The rehabilitation program developed for him is described in detail. RESULTS: Over the course of rehabilitation, which began in December 1999 and continues to this writing, the patient has regained locomotion capabilities (though with impairments), and his speech has improved considerably. The apraxia has largely resolved, and he is able to write his name and copy words. He is now capable of performing many activities of daily living. CONCLUSIONS: A comprehensive program of rehabilitation characterized by a strategic, heuristic approach is capable of achieving a good outcome even in very difficult cases, such as prolonged coma.- - - - - - - - - - ranking = 1keywords = aphasia (Clic here for more details about this article) |
4/52. speech and language findings in a chronic hemodialysis patient: a case report.The speech and language findings in one patient who underwent chronic hemodialysis therapy are presented. The patient's degenerating physical status was first signaled by stutteringlike repetitions. The speech diagnosis is mixed dysarthria, apraxia of speech, and aphasia. Clinical implications are discussed.- - - - - - - - - - ranking = 1keywords = aphasia (Clic here for more details about this article) |
5/52. Progressive affective aprosodia and prosoplegia.The right frontal lobe is important for the expression of emotional prosody, emotional faces, and automatic speech. The authors describe a woman who presented with progressive expressive affective aprosodia, affective prosoplegia, amusia, and loss of automatic speech but with an intact ability to understand emotional prosody and faces as well as express and understand syntactic prosody. MRI showed predominant right frontal cortical atrophy. The authors suggest that this patient has a form of frontotemporal dementia, analogous to primary progressive aphasia but disrupting right frontal lobe-mediated functions.- - - - - - - - - - ranking = 1keywords = aphasia (Clic here for more details about this article) |
6/52. Nothing to say, something to sing: primary progressive dynamic aphasia.We describe a 76-year-old man (ADY) with dynamic aphasia in the setting of a degenerative frontal lobe dementia: primary progressive dynamic aphasia. He displayed a striking paucity of propositional speech despite intact speech production, and preserved singing and prosody. Vocal expression in the verbal and musical domains was investigated in a series of neuropsychological experiments based on novel language and musical tasks that were designed to establish the nature and specificity of the verbal output deficit. The features of the language disorder indicated that the speech output pathway was disrupted at the early stage of generation of a new pre-verbal message. In contrast, tests of musical output demonstrated that the generation of new musical ideas was unimpaired. The domain-specificity of dynamic aphasia may result from the disruption of specific cognitive processes necessary for the creation of verbal messages, as well as selective damage of brain regions involved in language production.- - - - - - - - - - ranking = 7keywords = aphasia (Clic here for more details about this article) |
7/52. language function and dysfunction in corticobasal degeneration.OBJECTIVE:S: The authors assessed language functioning in corticobasal degeneration (CBD), an area that has received little systematic study. aphasia has been reported occasionally, and the authors hypothesized that appropriate assessments would reveal at least mild language impairment, particularly affecting phonologic (sound-based) processing, even in cases without frank aphasia. methods: A series of 10 unselected patients with CBD (one with pathologic confirmation) were administered neuropsychological tests assessing the following aspects of cognitive functioning: verbal fluency, naming, reading, oral spelling, auditory-verbal short-term memory, phoneme blending and segmentation, visuospatial skills, and semantic memory. RESULTS: Phonologic and spelling impairments were prevalent, even in nonaphasic patients. The prevalence of visuospatial, constructional, and frontal impairments, demonstrated in previous research, was also replicated. A minority of patients had deficits in semantic memory, naming, and reading, but the impairments were usually mild. CONCLUSIONS: The authors found phonologic impairment to be a typical feature of CBD. There is substantial overlap between progressive nonfluent aphasia and CBD, and the linguistic impairment can be thought of as a continuum, with mild phonologic impairment at one end and severe aphasia at the other.- - - - - - - - - - ranking = 3keywords = aphasia (Clic here for more details about this article) |
8/52. Slowed lexical access in nonfluent aphasia: a case study.A list priming paradigm (LPP) was used to examine the hypothesis that nonfluent aphasics are literally slowed down in automatic access to lexical information. In this paradigm, words are presented visually, and the subject's task is to make a lexical decision on each word as quickly as possible after its presentation. As soon as a lexical decision is made on one word, that word is removed and, after a predetermined interword interval, the next word is presented. In this way, a continuous "list" effect is obtained. Prior studies with both college-age and elderly subjects using the LPP have shown that, independently of age, on the LPP, priming obtains at interword delays of 500 to 800 msec, but not at either shorter or longer interword delays. In the study reported here, the LPP was used to examine delays at which priming obtained for LD, a nonfluent aphasic with a lesion primarily in the left frontal region. Examining interword delays ranging from 500 to 1800 msec, the subject showed priming only at a delay of 1500 msec, a considerably longer delay than that at which neurologically intact subjects have shown priming. Based on these results, it is argued that while automatic access is retained, that access is much slower in a nonfluent aphasic than in neurologically intact elderly subjects. These results are discussed in terms of how slowed lexical access might impact on discourse comprehension.- - - - - - - - - - ranking = 4keywords = aphasia (Clic here for more details about this article) |
9/52. Segregation of the neural correlates of language and phonological short-term memory.A left-handed patient is reported who developed a selective deficit of phonological short-term memory, but not aphasia, following an ischaemic lesion in the temporal parietal region of the left hemisphere The phonological short-term store was selectively damaged compared to the rehearsal system. The patient also showed impaired comprehension of spoken (but not written) connected language. This study suggests that language and phonological short-term memory may be mediated by segregated neural systems that develop independently in the two hemispheres. The relationship between phonological short-term memory and auditory comprehension is also discussed.- - - - - - - - - - ranking = 1keywords = aphasia (Clic here for more details about this article) |
10/52. Affective aprosodia from a medial frontal stroke.BACKGROUND AND OBJECTIVES: Whereas injury to the left hemisphere induces aphasia, injury to the right hemisphere's perisylvian region induces an impairment of emotional speech prosody (affective aprosodia). Left-sided medial frontal lesions are associated with reduced verbal fluency with relatively intact comprehension and repetition (transcortical motor aphasia), but persistent affective prosodic defects associated with right medial frontal lesions have not been described. methods: We assessed the prosody of a man who sustained a right medial frontal cerebral infarction seven years prior. RESULTS: While propositional speech expression was normal including syntactic prosody, the patient was impaired at expressing emotions using prosody. His comprehension and repetition of prosody were also impaired but less so than expression. CONCLUSIONS: Right medial frontal lesions can induce an affective aprosodia that primarily impairs expression.- - - - - - - - - - ranking = 2keywords = aphasia (Clic here for more details about this article) |
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