Bob is a 33-year-old right-handed man who was recently found sprawled on the floor by his wife. When he woke, he was dragging his right leg, had a right facial droop, and didn’t appear to understand anything said to him. After being rushed to the ER, the doctors diagnosed a dense right hemiparesis (weakness). Doctors also noticed that while his speech was rapid and fluent, he was quite unintelligible. He showed no slurring or stilting of his speech, and his overall articulation was fine. Bob had absolutely no trouble getting words out—the problem was that once they were out they made no sense!
During his neuropsychological assessment, his doctor asked him to repeat sentences such as “will you answer the telephone?” More often than not, he would answer the questions (“yes I will” or “no, it’s on the ground”) rather than repeat the sentence. His spontaneous speech was filled with neologisms (made-up words) and jargon. In fact, one of his doctors commented that Bob’s speech was reminiscent of the “Jabberwocky” poem by Lewis Carroll (i.e., “Twas brillig, and the slithy toves … Did gyre and gimble in the wabe”). Bob was unable to comprehend written text or write coherently (his written work read much like his spoken words sounded; fluent but empty). And, to all intents and purposes, Bob seemed completely unaware of his condition.
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?
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