A case of telegraphic speech : a right-handed man with small hemorrhage in the posterior portion of the left middle frontal gyrus

Abstract

    Telegraphic speech has been rarely reported in Japanese patients with Broca's aphasia and is rather known to be characteristic of crossed aphasics. We report on a 54-year-old, right-handed man with telegraphic speech but preserved comprehension, vocabulary and grammar.
    The patient experienced a sudden-onset severe anarthria and mild right hemiparesis without bucco-facial apraxia. He had difficulty writing, particularly in “kana” (phonograms) characters (paragraphia) : therefore his language disturbance was considered to be classified as Broca's aphasia according to Mori and his colleagues. As he improved over a few weeks in the quantity of speech output, telegraphic speech became apparent. It was limited in his spontaneous utterance and particularly overt when he tried to express himself urgently. CT and MRI revealed a small hematoma ( 2 × 2.3 cm at the beginning) in the posterior part of the left middle frontal gyrus. Two months after the onset the patient still showed evidence of a mild telegraphic speech.
    We speculate that the patient would have omitted “joshi” (particles) to produce as much information as possible. This phenomenon may be related to a dysfunction in the process of sentence construction, which has been reported to occur with a lesion in the posterior part of the left middle frontal gyrus.