Harrison's Manual of Medicine
Chapter 57: Aphasia
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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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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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