Harrison's Manual of Medicine
Chapter 57: Aphasia
Aphasias are disturbances in the comprehension or production of spoken or written language. Clinical examination should assess spontaneous speech (fluency), comprehension, repetition, naming, reading, and writing. A classification scheme is presented in Table 57-1. In nearly all right-handed individuals and many left-handed pts, language localization is in the left hemisphere.
| COMPREHENSION | REPETITION OF SPOKEN LANGUAGE | NAMING | FLUENCY | |
|---|---|---|---|---|
| Wernicke’s | Impaired | Impaired | Impaired | Preserved or increased |
| Broca’s | Preserved (except grammar) | Impaired | Impaired | Decreased |
| Global | Impaired | Impaired | Impaired | Decreased |
| Conduction | Preserved | Impaired | Impaired | Preserved |
| Nonfluent (anterior) transcortical | Preserved | Preserved | Impaired | Impaired |
| Fluent (posterior) transcortical | Impaired | Preserved | Impaired | Preserved |
| Isolation | Impaired | Echolalia | Impaired | No purposeful speech |
| Anomic | Preserved | Preserved | Impaired | Preserved except for word-finding pauses |
| Pure word deafness | Impaired only for spoken language | Impaired | Preserved | Preserved |
| Pure alexia | Impaired only for reading | Preserved | Preserved | Preserved |
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Citation
Kasper, Dennis L., et al., editors. "Chapter 57: Aphasia." Harrison's Manual of Medicine, 20th ed., McGraw Hill Inc., 2020. harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623194/all/Chapter_57:_Aphasia.
Chapter 57: Aphasia. In: Kasper DLD, Fauci ASA, Hauser SLS, et al, eds. Harrison's Manual of Medicine. McGraw Hill Inc.; 2020. https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623194/all/Chapter_57:_Aphasia. Accessed May 9, 2025.
Chapter 57: Aphasia. (2020). In Kasper, D. L., Fauci, A. S., Hauser, S. L., Longo, D. L., Jameson, J. L., & Loscalzo, J. (Eds.), Harrison's Manual of Medicine (20th ed.). McGraw Hill Inc.. https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623194/all/Chapter_57:_Aphasia
Chapter 57: Aphasia [Internet]. In: Kasper DLD, Fauci ASA, Hauser SLS, Longo DLD, Jameson JLJ, Loscalzo JJ, editors. Harrison's Manual of Medicine. McGraw Hill Inc.; 2020. [cited 2025 May 09]. Available from: https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623194/all/Chapter_57:_Aphasia.
* Article titles in AMA citation format should be in sentence-case
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