Chapter 57: Aphasia

Chapter 57: Aphasia is a topic covered in the Harrison's Manual of Medicine.

To view the entire topic, please or .

Harrison’s Manual of Medicine 20th edition provides 600+ internal medicine topics in a rapid-access format. Download Harrison’s App to iPhone, iPad, and Android smartphone and tablet. Explore these free sample topics:

-- The first section of this topic is shown below --

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.

TABLE 57-1: Clinical Features of Aphasias and Related Conditions Commonly Seen in Cerebrovascular Accidents
 COMPREHENSIONREPETITION OF SPOKEN LANGUAGENAMINGFLUENCY
Wernicke’sImpairedImpairedImpairedPreserved or increased
Broca’sPreserved (except grammar)ImpairedImpairedDecreased
GlobalImpairedImpairedImpairedDecreased
ConductionPreservedImpairedImpairedPreserved
Nonfluent (anterior) transcorticalPreservedPreservedImpairedImpaired
Fluent (posterior) transcorticalImpairedPreservedImpairedPreserved
IsolationImpairedEcholaliaImpairedNo purposeful speech
AnomicPreservedPreservedImpairedPreserved except for word-finding pauses
Pure word deafnessImpaired only for spoken languageImpairedPreservedPreserved
Pure alexiaImpaired only for readingPreservedPreservedPreserved

-- To view the remaining sections of this topic, please or --

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.

TABLE 57-1: Clinical Features of Aphasias and Related Conditions Commonly Seen in Cerebrovascular Accidents
 COMPREHENSIONREPETITION OF SPOKEN LANGUAGENAMINGFLUENCY
Wernicke’sImpairedImpairedImpairedPreserved or increased
Broca’sPreserved (except grammar)ImpairedImpairedDecreased
GlobalImpairedImpairedImpairedDecreased
ConductionPreservedImpairedImpairedPreserved
Nonfluent (anterior) transcorticalPreservedPreservedImpairedImpaired
Fluent (posterior) transcorticalImpairedPreservedImpairedPreserved
IsolationImpairedEcholaliaImpairedNo purposeful speech
AnomicPreservedPreservedImpairedPreserved except for word-finding pauses
Pure word deafnessImpaired only for spoken languageImpairedPreservedPreserved
Pure alexiaImpaired only for readingPreservedPreservedPreserved

There's more to see -- the rest of this topic is available only to subscribers.