Cases reported "Aphasia"

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1/124. Ictal paraphasia induced by language activity.

    Four patients with ictal speech disturbance were studied. Their seizures featured isolated, or series of, brief episodes of fluent paraphasia, paragraphia, and comprehension deficit. These episodes were often induced by language activity. Six patients with ictal paraphasia or paragraphia, as a recurrent habitual seizure, are reported in the literature. All ten cases, including the four cases described here and the six cases reported in the literature, featured patients who uttered meaningless speech fluently or displayed paragraphia. The syllables uttered during seizures contained many neologisms and resembled the neologistic jargon of patients with fluent aphasias of the Wernicke type. Nine patients had clusters or status of brief seizures and four patients had auditory hallucination as an ictal event. The seizures in six patients were easily induced by the use of language. Seizure focus was on the left side in all patients mentioned. The possibility of another type of language-induced seizures than those seen in reading epilepsy or language-induced epilepsy is suggested in which myoclonias of the jaw and face, or upper extremities are the main seizure types.
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ranking = 1
keywords = status
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2/124. A longitudinal perspective on the study of specific language impairment: the long-term follow-up of an Italian child.

    Most of the literature on children with specific language impairment (SLI) is centred on the study of cross-sectional samples and little is known on how language develops in these children--that is, whether it occurs along steps and modes analogous to those observed in normal acquisition, the only difference being significant slowness, or following rather idiosyncratic courses leading to atypical results. This paper presents findings from a longitudinal study of the acquisition of formal aspects of Italian grammar in a child with severe SLI of the so-called phonologic-syntactic subtype or grammatical SLI. The analysis concerns a set of morphosyntactic phenomena sufficiently differentiated in terms of both grammatical properties and modes of acquisition in normal development, so as to offer a panorama that approximates to what can be thought of as an overall morphosyntactic competence: (1) free morphology (prepositions, clitics and articles); (2) bound morphology (verb inflection); (3) WH movement (questions and relative clauses) and (4) the evolution of complex sentences. These phenomena will be dealt with in four independent studies. This paper argues that each domain or even each sub-domain presents its own set of properties, some of which are common to other domains but some of which are not. The results reveal the existence of important dissociations among the various domains and even within specific sub-domains. These dissociations may be ascribed to deficits affecting specific properties of functors or constructions. The picture that emerges is one in which the deficit involves, rather than morphology in the strict sense of a bare set of paradigmatic forms, some properties or components of syntax which are involved in the use, not only of certain morphemes, but of certain extended syntactic constructions as well. This result will be checked against the most widely held current theoretical approaches to SLI.
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ranking = 0.0042485834222606
keywords = complex
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3/124. functional neuroimaging of speech perception in six normal and two aphasic subjects.

    This positron emission tomography study used a correlational design to investigate neural activity during speech perception in six normal subjects and two aphasic patients. The normal subjects listened either to speech or to signal-correlated noise equivalents; the latter were nonspeech stimuli, similar to speech in complexity but not perceived as speechlike. Regions common to the auditory processing of both types of stimuli were dissociated from those specific to spoken words. Increasing rates of presentation of both speech and nonspeech correlated with cerebral activity in bilateral transverse gyri and adjacent superior temporal cortex. Correlations specific to speech stimuli were located more anteriorly in both superior temporal sulci. The only asymmetry in normal subjects was a left lateralized response to speech in the posterior superior temporal sulcus, corresponding closely to structural asymmetry on the subjects' magnetic resonance images. Two patients, who had left temporal infarction but performed well on single word comprehension tasks, were also scanned while listening to speech. These cases showed right superior temporal activity correlating with increasing rates of hearing speech, but no significant left temporal activation. These findings together suggest that the dorsolateral temporal cortex of both hemispheres can be involved in prelexical processing of speech.
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ranking = 0.0042485834222606
keywords = complex
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4/124. Forced hyperphasia and environmental dependency syndrome.

    A distinctive, language related fragment of the environmental dependency syndrome is described: compulsive, involuntary, environmentally dependent speaking. Because this syndrome represents the observe of aphasia, it is named forced hyperphasia. An 84 year old woman with acute left frontal infarction was admitted to hospital with gait disturbance, forced grasp reflex, and striking imitation behaviour. After 2 weeks her imitation behaviour disappeared, but an equally striking new behaviour emerged. In the presence of others she would call out the names of objects in the room, and also call out the actions and gestures of people in the room, even though she was not asked to do so, and even though she was asked to stop. For example, if the doctor scratched his nose, she said, "The doctor is scratching his nose." brain CT, MRI, and SPECT showed cerebral atrophy and a left superior frontal subcortical infarct. It is suggested that "forced hyperphasia" is a clinical fragment of the environmental dependency syndrome and that her compulsive, impulsive, involuntary release of spoken language resulted from the release of frontal inhibition of the complex reflex linking environmental cues to the set of motor, limbic, spatial, and linguistic associations underlying spoken language.
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ranking = 0.0042485834222606
keywords = complex
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5/124. Childhood epilepsy with neuropsychological regression and continuous spike waves during sleep: epilepsy surgery in a young adult.

    We describe the case of a man with a history of complex partial seizures and severe language, cognitive and behavioural regression during early childhood (3.5 years), who underwent epilepsy surgery at the age of 25 years. His early epilepsy had clinical and electroencephalogram features of the syndromes of epilepsy with continuous spike waves during sleep and acquired epileptic aphasia (landau-kleffner syndrome), which we considered initially to be of idiopathic origin. seizures recurred at 19 years and presurgical investigations at 25 years showed a lateral frontal epileptic focus with spread to Broca's area and the frontal orbital regions. Histopathology revealed a focal cortical dysplasia, not visible on magnetic resonance imaging. The prolonged but reversible early regression and the residual neuropsychological disorders during adulthood were probably the result of an active left frontal epilepsy, which interfered with language and behaviour during development. Our findings raise the question of the role of focal cortical dysplasia as an aetiology in the syndromes of epilepsy with continuous spike waves during sleep and acquired epileptic aphasia.
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ranking = 0.0042485834222606
keywords = complex
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6/124. Effects of morphological complexity on phonological output deficits in fluent and nonfluent aphasia.

    This study examined the effects of morphological complexity on aphasic speakers with lexical-phonological output deficits. Subjects were two fluent and two nonfluent aphasic speakers who repeated morphologically simple words at the same level of accuracy and whose errors were virtually all phonological in nature. They were asked to repeat a variety of morphologically complex (i.e., affixed) words. Results were interpreted within our two-stage model of lexical-phonological production (Kohn & Smith, 1994, 1995), which we expand to include a distinction between derivational and inflectional morphology. When comparing overall performance levels between morphologically simple and complex words, only three subjects exhibited more difficulty repeating the morphologically complex targets. Nevertheless, when comparing repetition accuracy between different types of morphologically complex words (e.g., derived vs. inflected), all four subjects displayed similar patterns. These findings suggested that while morphological complexity has different effects on the two stages within the lexical-phonological output system, the relative effects of different morphological structures are constant. At the level of error analysis, patterns of affix errors distinguished the nonfluent from the fluent subjects in ways that are reminiscent of the affix errors associated with agrammatic and paragrammatic speech. This finding raised questions concerning the relationship between morphosyntactic and morphophonological deficits.
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ranking = 0.047878122580988
keywords = complex, simple
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7/124. aphasia: the sole manifestation of focal status epilepticus.

    aphasia was the sole manifestation of focal status epilepticus in a man with an old left frontal contusion. The diagnosis was made by electroencephalogram (EEG), and the attack was terminated by anticonvulsant medication.
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ranking = 848.95490598206
keywords = status epilepticus, epilepticus, status
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8/124. Evidence for cognition without grammar from causal reasoning and 'theory of mind' in an agrammatic aphasic patient.

    Understanding the inter-relationship between language and thought is fundamental to the study of human cognition [1] [2] [3]. Some investigators have proposed that propositions in natural language serve to scaffold thinking, by providing, for example, a sequential structure to a massively parallel process [4]. Others have maintained that certain thoughts, such as inferring the mental states of others, termed 'theory of mind' (ToM) reasoning, and identifying causal relationships, necessarily involve language propositions [5]. It has been proposed that ToM reasoning depends upon the possession of syntactic structures such as those that permit the embedding of false propositions within true statements ('Mary knows that John (falsely) thinks chocolates are in the cupboard') [6]. The performance on reasoning tasks of individuals with severe agrammatic aphasia (an impairment of language following a lesion of the perisylvian areas of the language-dominant hemisphere) offers novel insights into the relation between grammar and cognition. We report the unusual case of a patient with agrammatic aphasia of such severity that language propositions were not apparently available at an explicit processing level in any modality of language use. Despite this profound impairment in grammar, he displayed simple causal reasoning and ToM understanding. Thus, reasoning about causes and beliefs involve processes that are independent of propositional language.
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ranking = 0.0026961441791912
keywords = simple
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9/124. Focal cortical dysplasia of the temporal lobe with late-onset partial epilepsy: serial quantitative MRI.

    We describe serial studies of focal cortical dysplasia causing temporal lobe seizures and progressive aphasia in a 54-year-old woman. Initially, MRI volumetry of the temporal lobes showed significant left cortical thickening corresponding to an elevated amino-acid uptake in the left temporoparietal and inferior frontal cortex on SPECT using 3-[123I]iodo-alpha-methyl-L-tyrosine (IMT). After 1 year there was severe shrinkage of the left temporal lobe, possibly the result of recurrent complex partial seizures.
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ranking = 0.0042485834222606
keywords = complex
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10/124. Persisting aphasia as the sole manifestation of partial status epilepticus.

    OBJECTIVES: Persisting aphasia presenting as an isolated inability to vocalize is an uncommon presentation of simple partial status epilepticus and only eight such cases have been reported over the past 40 years. methods: We studied a patient with a 5-year history of recurrent episodes of inability to talk, without any other motor or cognitive impairments. Episodes lasted as long as 24 h, interictal EEGs were normal and she was diagnosed as a conversion disorder. RESULTS: EEG recordings during one of the episodes showed continuous discharges in the right frontal and parasagital areas demonstrating the ictal nature of the deficits. During the episode the patient had no deficits of strength, or in her ability to perform skilled movements to command, imitation or manipulation of objects. comprehension of complex verbal commands was preserved and she would make attempts to articulate words and correctly answered questions with head nodding or monosyllables, yes or no. She could hum but had no other vocalizations. CONCLUSIONS: This is the first case of aphasic status epilepticus secondary to epileptogenic discharges of the right hemisphere. The case is also unique for the isolated involvement of production of language during the seizure.
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ranking = 3033.2376565818
keywords = partial status epilepticus, status epilepticus, partial status, epilepticus, status, complex, simple
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