Louis is a right-handed man in his mid-50s who has recently suffered from a cerebrovascular accident (CVA). This has left him with a right-sided hemiparesis (weakness) and significant language issues. In particular, Louis’s right arm and hand were too weak to grasp anything.
During the first week after his CVA, Louis was unable to utter more than single words. This was incredibly frustrating for him, but he was able to communicate using Scrabble tiles (he could spell out nongrammatical and misspelled sentences of three or four words). He appeared to understand what was being said to him, and his communications did answer inquiries, although they were very sparse and lacking in “smoothness” (he often sounded like Tarzan when he spoke).
Over the next few weeks, his speech improved slightly although it was still clearly very difficult for him. He was able to articulate short sentences with few function words, but his prosody was lacking. When Louis spoke, he sounded like a robot (lacking in emotional tone) no matter what he said. He could, however, repeat simple sentences spoken to him.
Questions
- What condition or conditions (there may be more than one possibility) are being described in this case?
- What brain area or area(s) may be involved (be sure to consider which language functions are compromised too, and be specific as to which hemisphere)? How should they function normally? What could be causing this dysfunction?
- What do the patient’s symptoms tell you about his language abilities and how they may be impaired?
Originally published at http://www.sciencecases.org/mini_aphasia/2Louis.asp
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