2010 Volume 30 Issue 4 Pages 533-538
We reported the case of a 67-year-old right-handed female who presented crossed Broca's aphasia with buccal-lingual-facial apraxia. Under MRI, this lesion was localized to the right middle-lower part of the precentral gyrus and operculum of the inferior frontal gyrus. A single photon emission CT (SPECT) demonstrated hypoperfusion of the same areas. The concurrence of symptoms of aphasia with a right hemisphere lesion led us to hypothesize a mirror image type of crossed aphasia that is analogous to aphasia caused by a left hemisphere lesion in a right-handed patient. The misreactions observed in the scope of buccal-lingual-facial apraxia were parapraxia and vocal leak, and characteristically the latter was frequent. The kinds of misreactions were similar to cases of motor aphasia due to a left hemisphere lesion ; consequently, this buccal-lingual-facial apraxia was considered to be a “mirror image type.“ This case suggests that hemisphere differentiation, with respect to language function lateralized in the right hemisphere, can be present in extremely localized form in the same way as in the left hemisphere.
