Abstract
A case of global aphasia with recurring utterances (RUs) was reported. The clinical course was unique in that real word RUs (RWRUs) evolved to non-meaningful RUs (NMRUs).
A 73-year-old right handed woman awoke with numbness in her right extremities and with difficulty in speaking. On admission, one day after onset, she was drowsy and had right hemiplegia. Her conciousness became alert on the 6 th hospital day, but she was unable to pronounce any intelligible words. She could not follow simple commands, repeat single words, read aloud or write her name. About 10 days after onset, she began to utter " anta " ( = you) when attempting to speak. Other utterances were not observed except for one or two unintelligible phonemes. About 50 days after onset, her RU changed from RWRU to NMRU. In the transition period, several forms of NMRU were observed, such as " tsuta : n " " ta-ta-ta " " tsu-tsu-tsu " " tsu-ta-ta-ta " , but they soon gave way to " tantan " or " tanta : n " . CT and MR imaging showed a large infarct involving left basal ganglia, corona radiata and parietooccipital lobes but sparing Broca and Wernicke areas. Single photon emission computed tomography, however, demonstrated low RI uptake in the whole left hemisphere.
Evolution from RWRU to NMRU observed in our case could be explained by the assumption that severely damaged phonological system of the left hemisphere modified RWRU of right hemisphere origin.
