Abstract
From the analysis of the symptom of 19 patients with Wernicke's aphasia, they were classified into following subtypes. 1) Disturbed repetition type-1 : Disturbance in repetition was prominent. Disturbed auditory comprehension became mild. Anomia disappeared rapidly. The lesion involved the left transverse temporal gyrus and auditory radiations. Disturbance of phonetic discrimination seemed to be responsible of this type. 2) Disturbed repetition type- 2 : Disturbance in repetition, auditory comprehension, and naming was prominent. Phonemic paraphasia and neologism was observed. The lesion involved the posterior half of the left superior temporal gyrus. Disturbance in phonemic recognition seemed to cause this type. 3) Disturbed semantic comprehension type : Auditory comprehension was disturbed despite preserved ability to repeat the word. Semantic paraphasia and neologism was observed. The lesion involved the anterior half of the left superior temporal gyrus and extensive region of the middle temporal gyrus. 4) Mixed disturbance type : Severe Wernicke's aphasia which had characteristic of both the “Disturbed repetition type-2” and the “Semantic comprehension type” . The lesion included both the left superior temporal gyrus and the middle temporal gyrus. 5) Mild disturbance type : Mild Wernicke's aphasia which could be classified neither into “Disturbed repetition type” nor “Disturbed semantic comprehension type” . 6) Transcortical sensory aphasia : Disturbance of auditory comprehension and naming was severe, but repetition was almost normal. Echolalia was often observed.
Speech therapy of sensory aphasia should be done by the manner corresponding to these subtypes. Facilitation of discrimination, recognition, and retention of speech sound is necessary for 1) and 2). Facilitation of lexical or semantic recognition is essential for 3) and 6). Phonemic stimulation, then lexical or semantic facilitation is necessary for 4).
