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KMID : 0960920030020010070
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Dementia and Neurocognitive Disorders
2003 Volume.2 No. 1 p.70 ~ p.74
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Transcortical Mixed Aphasia Following Left Anterior Cerebral Artery Infarction
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Shim Mi-Sup
Lee Yeon-Su
Kim Yun-Hui
Lee In-Suk
Han Seol-Heui
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Abstract
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We present a case of transcortical mixed aphasia (TMA) presumably caused by left anterior cerebral artery infarction. A 53-year-old, right-handed woman suddenly developed speech disturbance and abnormal behavior. Her spontaneous speech was remarkably reduced to almost mutistic state and objective naming, comprehension, reading and writing were severely impaired. However, repetition of phonemes and sentences were fully preserved. She showed echolalia and completion phenomenon, which prompted us to make a diagnosis of TMA. Although the lesion was confined to extrasylvian area on MRI, SPECT demonstrated diminished blood flow left perisylvian cortices suggestive of functional isolation of speech area. In spite of her echolalic repetition, she couldn’t repeat affective prosody, presumably, because of the left anterior corpus callosal lesion. Treatment with bromocriptine, a dopamine agonist helped her recovery of behavioral changes, namely abulia or akinetic mutism consistent with mesial frontal syndrome.
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KEYWORD
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Transcortical mixed aphasia (TMA), Mesial frontal syndrome
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