2022 Volume 63 Issue 2 Pages 103-114
We report the characteristics of untranscribable jargon in a 68-year-old right-handed man with aphasia following a cardiogenic cerebral embolism. He presented unclear articulation in spontaneous speech at an early stage following the onset and fluently uttered something difficult to transcribe phonetically using Japanese characters. The patient maintained auditory comprehension ability at the levels from single syllables to short sentences. This case was characterized by the following three elements: (1) contrast between fluent untranscribable jargon at the conversation level in spontaneous speech and non-fluent utterance in clinical testing, (2) impairment of utterance monitoring, and (3) severe phonological processing disorder. At a later stage, the patient's articulation gradually became clear over time, and his problems converged to conduction aphasia with predominant symptoms of fragmented phonemes and phonemic paraphasia 6 months after the onset. The untranscribable jargon observed at the early stage in this case may be attributed to a severe phonological structurization disorder in addition to alalia and a monitoring disorder for spontaneous speech. These functional disorders are likely to have originated from cortical and subcortical damage to the left precentral gyrus, postcentral gyrus, and the superior temporal gyrus.