1994 Volume 14 Issue 4 Pages 258-264
We report a patient with aphemia, whose speech has remarkably improved by using the mora-by-mora finger counting method. The patient was a 61-year-old right handed man. He developed dysesthesia in the right hand at the beginning of October, 1989, followed paresis in the right extremity in the middle of the month, and became dumb after awakening on the morning of 25th October. He admitted to the hospital on 20th November. MRI revealed an infarction involving left precentral gyrus and underlying white matter. His spontaneous speech was nonfluent, dysprosodic, effortful, its each phoneme was expressed separately with prominent phonemic paraphasias, ill articulation and recurrence of the same phoneme. His auditory comprehension and reading comprehension were intact with slight difficulty in recalling words and a few writing mistakes. His clinical feature was diagnosed as aphemia without any effect on delayed auditory feedback (DAF). We have introduced tne mora-by-mora finger counting method at reading aloud sentences of 28 ˜ 40 syllables one year and three months after the beginning of speech training. As the result, we found prominent improvement in his speech. He showed less effortful,rapid and better articulation using the method. Futher, he showed these improvement without finger counting just after the exercise of sentenes using the method. We also present this remarkable improvement by sound spectrography. We suppose that the finger counting of the mora-by-mora method might control the rythn of each word, and stabilize the feedback of the patient's own utterance. Thus the somatosensory passway using finger counting might urge expressio of words except for auditory feedback.
