2021 Volume 41 Issue 1 Pages 31-37
We report here an interesting case, who demonstrated phonemic paraphasia and disability of repetition postoperatively after a lesionectomy in the left opercular part of the frontal lobe, that is, main part of classical Brocaʼs area. She was in her 30s with uncontrolled epilepsy. Surgery was performed for control of epilepsy, under awaken condition with monitoring for language function. Intraoperatively, when the cortex was gently removed by piecemeal fashion in the left opercular part and subcortical fibers was explored, she presented phonemic paraphasia. Postoperatively, she demonstrated many phonemic and paraphasic errors despite of well-preserved auditory and visual comprehension, similar to conduction aphasia. This case showed important findings for the neural basis of language. A damage in subcortical fibers running beneath the cortex of the opercular part can cause phonemic paraphasia and disability of repetition. Those fibers were considered a part of the SLF (superior longitudinal fasciculus) III, and/or arcuate fasciculus. To comprehend the relationship between the anatomy and symptoms, hodological approach considering brain networks is necessary.
