Abstract
We present the case of a right-handed male in his late seventies suffering from aphemia due to bilateral cerebral hemispheric lesions who was in denial of his articulatory disturbance. Computed tomography revealed a left-hemispheric lesion extending from the precentral gyrus to its peripheral areas and a right-hemispheric lesion extending from the superior temporal gyrus to the supramarginal gyrus. Speech-language examination showed normal comprehension (both auditory and reading) and a slight deficit in writing. On the basis of the location of the lesions and the results obtained from speech-language examination, the patient was diagnosed as a case of aphemia caused by a left-hemispheric lesion. Although the patient underwent speech therapy for his articulatory disturbance over a period of two years, there was no improvement in his articulatory disturbance. When assigned self-evaluation of speech utterance, the patient remained in denial of articulatory disturbance despite having normal auditory comprehension.The deficit in self-awareness was also investigated.
