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Wernicke's aphasia; fluent aphasia; garbled speech
Etiology:
1) cerebral ischemia
- in the distribution of the lower division of the middle cerebral artery
- stroke vs transient ischemic attack
2) Herpes simplex encephalitis
3) brain tumor
Pathology:
- lesion of the posterior perisylvian structures of the parietal & temporal lobes
Clinical manifestations:
1) fluent speech
2) total incomprehension of spoken speech
3) inability to read or repeat sounds or words
4) alexia
5) agraphia
6) paraphasia is common
7) associated manifestations
a) parietal lobe sensory deficits
b) hemianopsia
c) no motor disturbance
8) anomia, word-finding difficulty (dysnomia) Special laboatory:
- if acute, transient
- electrocardiogram
- carotid ultrasound [3]
Radiology:
- consider neuroimaging
- consider CT angiography of head & neck [3]
Related
paraphasia
General
aphasia
References
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 158-161
- Comprehensive Geriatric Assessment, Osterweil et al eds,
McGraw Hill, New York, 2000, pg 75
- Geriatric Review Syllabus, 10th edition (GRS10)
Harper GM, Lyons WL, Potter JF (eds)
American Geriatrics Society, 2019