Rehabilitation for Stroke with Auditory Agnosia as the First Symptom: Four Cases Report / 中国康复理论与实践

Objective:To study the clinical characteristics, diagnosis, treatment and rehabilitation of auditory agnosia after stroke. Methods:Four stroke inpatients with auditory agnosia as the first symptom from January, 2016 to August, 2018 were reviewed. Results:All the patients started with auditory impairment, followed with motor dysfunction and speech impairment. They had a previous history of cerebrovascular disease once or more, and were finally diagnosed as auditory agnosia after stroke. After comprehensive rehabilitation treatment, all the patients could walk independently, and the activities of daily living were improved. Some patients could discriminate environmental sound, but still were poor in listening comprehension. Conclusion:Post-stroke auditory agnosia is rare, with poor outcome, which needs comprehensive assessment, speech perception training and non-verbal communication training to improve the communication.

Damage Level and Mechanism of Language Processing in An Auditory Agnosia Patient Using Psycholinguistic As-sessment / 中国康复理论与实践

Objective To evaluate the damaged level of auditory processing and diagnose the type of language impairment in an audito-ry agnosia patient using Psycholinguistic Assessment in Chinese Aphasia (PACA), and predict the outcome of the language function. Meth-ods A patient with a bilateral damage involving the temporal lobe could physically hear the sounds, but was unable to recognize or differenti-ate between the sounds. Speech and language evaluations were taken with PACA 4 weeks, 8 weeks and 3 months after the onset of disease. Results At 4 weeks, the correct rates were 2.5%and 95.0%in spoken word-picture matching and written word-picture matching (P<0.001), and were 5.6%and 80.6%in spoken semantic knowledge and written semantic knowledge (P<0.001). The scores of auditory input process-ing function score were low, including phoneme discrimination, spoken word matching with minimal differences, environmental sounds identification. The correct rates were 67.5%in oral picture naming, 0 in word repetition, 70.0%in word reading, 0 in dictation, 100.0%in di-rectly copy writing. At 8 weeks and 3 months, there was complete recovery in written word-picture matching (both 100%) and written se-mantic knowledge (97.2%, 100%), and improvement in oral picture naming (87.5%, 90%), word repetition (87.5%, 97.5%), picture name writing (77.5%, 87.5%) and copy writing (both 100%) (P<0.05). But no change was found in auditory input processing function examina-tions, spoken word-picture matching (5.0%, 7.5%), spoken semantic knowledge (2.8%, 5.6%), word repetition (0, 3.3%) and dictation (both 0). Conclusion The patient was diagnosed as auditory agnosia with the inability to distinguish sounds. PACA can well identify the impaired level of auditory comprehension disorder and the outcome of language function recovery for aphasics.

Damage Level and Mechanism of Language Processing in An Auditory Agnosia Patient Using Psycholinguistic Assessment / 中国康复理论与实践

@#Objective To evaluate the damaged level of auditory processing and diagnose the type of language impairment in an auditory agnosia patient using Psycholinguistic Assessment in Chinese Aphasia (PACA), and predict the outcome of the language function. Methods A patient with a bilateral damage involving the temporal lobe could physically hear the sounds, but was unable to recognize or differentiate between the sounds. Speech and language evaluations were taken with PACA 4 weeks, 8 weeks and 3 months after the onset of disease. Results At 4 weeks, the correct rates were 2.5% and 95.0% in spoken word-picture matching and written word-picture matching (P<0.001), and were 5.6% and 80.6% in spoken semantic knowledge and written semantic knowledge (P<0.001). The scores of auditory input processing function score were low, including phoneme discrimination, spoken word matching with minimal differences, environmental sounds identification. The correct rates were 67.5% in oral picture naming, 0 in word repetition, 70.0% in word reading, 0 in dictation, 100.0% in directly copy writing. At 8 weeks and 3 months, there was complete recovery in written word- picture matching (both 100%) and written semantic knowledge (97.2%, 100%), and improvement in oral picture naming (87.5%, 90%), word repetition (87.5%, 97.5%), picture name writing (77.5%, 87.5%) and copy writing (both 100%) (P<0.05). But no change was found in auditory input processing function examinations, spoken word-picture matching (5.0%, 7.5%), spoken semantic knowledge (2.8%, 5.6%), word repetition (0, 3.3%) and dictation (both 0). Conclusion The patient was diagnosed as auditory agnosia with the inability to distinguish sounds. PACA can well identify the impaired level of auditory comprehension disorder and the outcome of language function recovery for aphasics.

A Case of Pure Word Deafness in MELAS Syndrome

An 18-year-woman was referred with seizure activity and global aphasia. Diagnosis of MELAS syndrome with left temporo-parieto-occipital infarction was confirmed by gene analysis. Global aphasia was improved completely. Right temporal infarction developed after 5 months. Diagnosis of pure word deafness was made in view of impaired verbal comprehension in presence of adequate reading, writing, spontaneous speaking, and well preserved environmental sound perception. MRI findings of the patient support the hypothesis of the pathway of non-verbal hearing in previous reports.