An ambidextrous agrammatic patient with diffuse cerebral infarction in the right hemisphere, showing notable “telegraphic speech,” was investigated for the production of case-marking particles through two kinds of picture-description tasks. The first task was an ordinary picturedescription, in which most of the patient's responses conformed to the subject-object order, thus suggesting his relatively preserved ability to construct so-called “cannonical word orders.” On the second task, in which the patient described pictures using predetermined “sentence-frames” specifying the constructions of sentences to be produced, he made substantial errors in particles when the sentence-frames were those with non-cannonical noun phrase (NP) orders or those which contained only object NP's. The latter result suggested that the patient would rely on the information of NP order in selecting particles. The patterns of errors in the responses in the two tasks suggested that not only separate particles but also “plausible sequences” of particles which would correspond to cannonical NP orders might be preserved, and that such particle sequences could be erroneously activated through utilizing NP-sequence information. The main disturbance in the patient seemed to consist in selecting precise particles and/or in suppressing plausible but inappropriate particles, while he was able, if not accurately, to select particles relying on NP-sequence and/or semantic cues. From these data, it appeared that the grammatical function of precise selection of particles might be localized in the right hemisphere in the patient, whose language lateralization could be anomalous as suggested by his ambidextrosity.

View full abstract

    We examined depth-EEG recordings of nine verbal automatisms and five aura experiences in a female patient, who was a candidate for the temporal lobectomy because of intractable temporal lobe epilepsy. As a result, we found that hippocampal recruiting theta activity in nondominant hemisphere is essential to the manifestion of verbal automatism and additional hippocampal theta activity in dominant hemisphere often precipitates the advent of the verbal automatism.
    It was noteworthy that the patient remained conscious while she issued her stereotyped utterance in one verbal automatism. She had an impression that it was not forced to say, but that it slipped from her lips. This probably indicated that verbal automatism could not be regarded as a kind of involuntary movement but as a spontaneous response to a specific experience evoked through excitation of a wide range of neuronal structure with non-dominant hippocampal formation as a core structure.

View full abstract

    The authors discuss a case of lip-reading rehabilitation for central auditory disorder following bilateral putaminal hemorrhages. The patient was a right-handed 54-year-old male. The initial attack took place on December 23, 1977 due to left putaminal hemorrhage. The patient developed right hemiplegia and aphasia. After one month, he had improved and returned to his former job. A second attack, on May 1, 1991, was caused by right putaminal hemorrhage, and was treated by surgical removal of a hematoma. After surgery, the patient showed left hemiplegia and hearing loss. However, he communicated by writing, and did so well that he initially paid no attention to his hearing loss. Nevertheless, later he considered it a serious handicap, at which time he was referred to our hospital to develop better means of communication.
    Lip-reading rehabilitation was started in Octorber 1991. Cued-speech was used to improve lipreading. After training, the patient's Picture Vocabulary Test and Token Test scores both improved. However, correct answers decreased with an increasing number of syllables and performance was affected by the order of syllables, words and sentences. Even after more than one year of training, combined use of lip-reading and cued-speech proved impractical for the patient. Moreover, his hearing did not improve at all. He continued to communicate by writing as before.

View full abstract

    We report a case of naming difficulty and alexia with agraphia of Kanji due to herpes simplex encephalitis. The patient was a 19-year-old right-handed woman. Naming difficulty was detected during a confrontation naming test of 100 words four months after the appearance of symptoms. The rate of error response was 86 %. Alexia with agraphia of Kanji was determined based on reading and dictation tests. We tested the subject at 14 ˜ 15 months after the appearance of symptoms. The rates of error were as follows : reading 57 %, dictation 77 %. We found the following common features in errors between confrontation naming and reading/dictation of Kanji: verbal paraphasia, paralexia and paragraphia. A symptom similar to Gogi aphasia like paragraphia caused by same or similar sounds was shown. X-ray CT and MRI revealed lesions in the left-anterior temporal lobe, left-anterior ˜ posterior inferior temporal gyrus and right-anterior temporal lobe. We attributed naming difficulty to the left-anterior temporal lobe, alexia and agraphia of Kanji to the left-posterior inferior temporal gyrus. We speculate that the left-inferior temporal lobe may play an important role in semantic word function.

View full abstract

    A case with marked and peculiar echolalia accompanied by aphasia following cerebro-vascular disease was reported. The case was a right-handed 63-year-old male. MRI showed lesions in the left medial frontal lobe and the anterior part of the left basal gangulia with some extension to the inferior frontal gyrus, insula, precentral gyrus and corona radiata. The case was described in detail and the following characteristics of this echolalia were discussed. (1) The echolalia present was characteristic of “effortful echolalia” (Hadano, et al.). (2) Recovery of echolalia was not as great as that of comprehension disorders. (3) This echolalia took the following course : no echolalia (total aphasia) → complete, mitigated and partial echolalia (atypical mixed transcortical aphasia) → complete and mitigated echolalia → mitigated echolalia.

View full abstract

    Three cases of an aphasic syndrome presenting prominent monemic paraphasia (paraphasie monémique ; Lecours) were reported. All cases developed fluent aphasia after left putaminal hemorrhage. Language features were summarized as follows; spontaneous speech was fluent with irrelevant paraphasia. A Large amount of monemic paraphasia was observed on naming tasks, and naming was not facilitated by phonemic cueing. Comprehension and repetition were fairly good.
    The cases presenting monemic paraphasia which has been reported until now were accompanied by confusion, denial of illness, or mood changes and the responsible lesions were not specified in most cases.
    In our cases, such symptoms above mentioned were not observed. It was suggested that the subcortical damages involving basal ganglia and/or thalamus, with cortical region being left intact, played an important role in the pathogenesis of monemic paraphasia.

View full abstract