Global Aphasia without Hemiplegia: Three Case Report

全失性失語症無合併半身偏癱：三病例報告

陳思甫(Szu-Fu Chen) ； 劉燦宏(Tsan-Hon Liou) ； 王榮俊(Zong-Jing Wang) ； 連倚南(I-Nan Lien)

《中華民國復健醫學會雜誌》 24卷1期 (1996/06) Pp. 79-85

摘要

全失性失語症是失語症中最嚴重的一型，臨床上多肇因於左大腦病變；且病人通常都有合併右半身偏癱。然而，病人也可能並無運動功能障礙。過去的文獻報告指出，大部份全失性失語症而無合併半身癱瘓的病例多肇因於腦栓塞。
本研究提出三例全失性失語症而無合併半身癱瘓之個案；三例皆肇因於腦血管病變。電腦斷層及核磁共振檢查顯示其病變區域如下：一為左顳頂葉梗塞，一為左額顳頂葉梗塞，另一位則為左顳頂葉出血；三例皆非腦栓塞之病例。三位患者在語言功能都有顯著的進步。在發病三個月後，第一、二位病患轉型為接受型失語症，第三位病患在語言功能方面則近乎正常。
由本研究經驗，全失性失語症而無合併半身癱瘓的病例在語言功能方面預後極佳。

關鍵字

全失性失語症 ； 偏癱 ； 腦血管病變

並列摘要

Global aphasia is the most severe form of language disorder. It is characterized by an extensive lesion involving the entire left perisylvian lesion and is usually accompanied by a dense right hemiplegia. However, it may be associated with only minimal and transient motor deficit. Most of the previous reports indicated that embolism was the most possible etiology of global aphasia without hemiplegia.
Here we present three patients who acutely developed global aphasia without hemiplegia as a result of stroke. These patients were examined in both acute and chronic stages. Computerized tomography and magnetic resonance imaging studies demonstrated that one patient had a single temporoparietal infarct, one had a single frontotemporopareital infarct and one had a temporoparietal hematoma. There was good recovery of verbal communication abilities. By three months after onset, two could be classified as having a residual sensory aphasia and another a nearly normal speech.
Our cases indicate that global aphasia without hemiplegia predicts a particularly good recovery of speech.

並列關鍵字

global aphasia ； hemiplegia ； stroke