Sherman is a right-handed man in his mid-50s. He suffered a head injury 30 years ago that had caused a variety of problems including post-traumatic amnesia and residual right-sided hemiparesis (weakness) for about two weeks. However, he eventually recovered his mobility.
More recently, Sherman began experiencing somewhat severe seizures that were fairly well-controlled by phenobarbitol. However, in the past few years Sherman has been neglectful in taking his medication and his seizures have worsened significantly. He has continued experiencing right-sided hemiparesis that has progressively increased, and his face has begun to droop.
Along with these seizures, Sherman has been experiencing difficulties with reading. Prior to his seizures Sherman was an avid reader, but his recent difficulties have removed much of the pleasure for him. Sherman finds that he has no problem with high-frequency words like “and,” “it” and “boy” (he can still read them with relatively little difficulty). However, when he encounters irregular words, especially low-frquency words like “colonel” and “thyme,” he can’t read them well at all (he sounds them out letter-by-letter, “culoneel” and “thymee”).
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/3sherman.asp
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