Internal Medicine

P1: SBT

0521779407-04 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:8

Aphasia 149

Aphasia...........................................

MICHAEL J. AMINOFF, MD, DSc

history & physical

Expressive (Broca) aphasia

■Speech telegrammic or lost; repetition, reading aloud & writing

impaired

■Associated features may include right hemiparesis, hemisensory dis-

turbance

Receptive (Wernicke) Aphasia

■Impaired comprehension & speech repetition; fluent but meaning-

less spontaneous speech; word salad; paraphasic errors; dysnomia

■Associated features may include right hemianopia

Global Aphasia

■Motor+receptive aphasia

Conduction Aphasia

■Impaired repetition

tests

■Cranial MRI or CT: lesion in inferior frontal region (expressive apha-

sia) or posterior part of superior temporal gyrus (receptive aphasia);

may be diffuse cerebral atrophy if aphasia is part of global cognitive

impairment

differential diagnosis

■Aphasia is symptom, not diagnosis

■Most common causes are stroke, tumor, dementing disorder

management

■Depends on cause (nature of lesion on imaging study)

treatment

■Treat underlying cause

■Speech therapy

specific therapy

N/A

follow-up

N/A

complications and prognosis

■Depend on cause