ABSTRACT
We report the first case, to our knowledge, of successful return to work of a patient with alexia without agraphia. This case is also interesting as it is the first report of which we are aware of anosognosia for alexia without agraphia: the patient confabulated when asked to read English text, but immediately stated that he could not read Chinese text because he did not know that language. The selective nature of this confabulation would not be inconsistent with anosognosia being one of the brain's responses to absence of afferent information.
Subject(s)
Agnosia/diagnosis , Agnosia/physiopathology , Alexia, Pure/diagnosis , Alexia, Pure/physiopathology , Stroke/diagnosis , Stroke/physiopathology , Agnosia/rehabilitation , Alexia, Pure/rehabilitation , Humans , Male , Middle Aged , Occipital Lobe/diagnostic imaging , Occipital Lobe/pathology , Occipital Lobe/physiopathology , Radiography , Stroke Rehabilitation , Temporal Lobe/diagnostic imaging , Temporal Lobe/pathology , Temporal Lobe/physiopathology , Thalamus/diagnostic imaging , Thalamus/pathology , Thalamus/physiopathologyABSTRACT
Patients with Wernicke's or expressive aphasia are able to produce fluent speech, however, this speech may be complete gibberish sounds and totally incomprehensible, or even when comprehensible to a degree is often laced with severe errors and abnormalities such as verbal and phonemic paraphasias and neologisms. Furthermore, patient's with Wernicke's aphasia have poor to no understanding of speech or language. There is no proven method for rehabilitation of Wernicke's aphasia, or even much guidance for physicians or speech therapists to treat Wernicke's aphasia patients. In contrast to their poor to non-existent communication skills using speech or other forms of language, it has long been appreciated informally and formally that Wernicke's aphasia patients are able to communicate well, even normally, using non-verbal means such as actions, movements, props, gestures, facials expressions, and affect. Furthermore, in non-language domains Wernicke's aphasia patients can show normal memory and learning abilities. Thus, we here suggest that the non-language communication channels of Wernicke's aphasia patients be channeled and utilized in their functional rehabilitation: Specifically, we suggest that therapy for Wernicke's aphasia patients should consist of placing patients in real or simulated important functional situations--e.g., buying food, taking transport--and let the patients train and learn to use and hone their non-language communication means and skills for improved practical functioning.
