A case of fluent aphasia with monemic paraphasia following left putaminal hemorrhage

Abstract

  We report a case of fluent aphasia exhibiting persisting monemic paraphasia following a left putaminal hemorrhage. The patient was a 64-year-old, right-handed woman with no confusion and with preserved non-verbal cognitive function. She had word finding difficulties and produced various paraphasias in spon taneous speech and in confrontation naming. Monemic paraphasia in naming was particularly marked. How ever, she made no errors in word or non-word repetition tasks and had intact auditory comprehension for short sentences. She showed monemic paraphasias even one year after the onset, which were classified into perseverative and non-perseverative type. Perseverative monemic paraphasias consisted of a previously produced moneme and a semantically related word, but many monemic paraphasias did not include a target word. On the other hand, many non-perseverative monemic paraphasias included a target word or a seman tically related word. Perseverative monemic paraphasias tended to gradually decrease over time. These findings suggest that the monemic paraphasias were based on various dysfunctions including the perse veration at the semantic and kinematic level and the disorganized activation of related and unrelated words. Dysfunction of the left basal ganglia might be related to monemic paraphasias.