- 期刊
雙語失語症患者兩種語言不同程度之損傷與恢復：病例報告
Differential Impairment and Recovery of Two Languages in a Bilingual Aphasic Patient: A Case Report
摘要
世界上的人口約有一半以上為能說多種語言的人(multilingual)，因此很多腦中風後的失語症病患屬於雙語性失語症(bilingual aphasia)，其臨床表現較使用單一種語言的人(monolingual)更加的複雜多變，必需給予更為個別化的語言評估與復健治療計劃，否則易誤診為單一種語言的失語症而減低治療效果。 本研究報告提供一位母語為廣束話且北京話流利的中國大陸籍的外籍新娘，中風後導致雙語性失語症，經半年的復健治療後，溝通能力進步了，北京話聽覺理解能力有些許的進步但仍不佳，表達能力及流暢度則無顯著進步，大部分需靠肢體語言作為輔助，廣東話的部份則接近正常，不管是聽覺理解或表達能力均明顯優於北京話。 學習語言的年紀或方式不同可能會影響兩種語言區的位置，加上腦部血流的再灌流或側枝循環的建立造成梗塞病灶的縮小，於是病患的語言功能有進一步的恢復且兩種語言呈現不同的恢復，恢復的形式並符合“Pitres”規則及“Ribot”法則。由於目前沒有針對在臺灣普遍使用的各種語言之雙語性失語症的評估工具，因此未來除了須制訂符合臺灣需求的雙語失語測驗(bilingual aphasia test)修訂版本外，並可進一步評估何種語言的復健治療對病人的預後較佳。
並列摘要
According to the definition proposed by Grosjean, more than half of the world population is multilingual. Bilingual aphasia is more complex and variable; thus it may need a more individualized rehabilitation program than monolingual aphasia. However, many instances of bilingual aphasia may have been misdiagnosed and treated as monolingual aphasia due to a lack of comprehensive assessment. We present here a change in the language pattern of a bilingual Chinese woman, who initially spoke Cantonese (mother language) and Mandarin (2nd language) very well. She was afflicted by aphasia due to a stroke involving cortical and subcortical lesions in 1999. After rehabilitation for 6 months, her general communication skills improved but she was still unable to fluently express herself in Mandarin, frequently requiring the help of gestures. However, she was able to comprehend and express herself in Cantonese for most daily activities. The differing functional recovery of the two languages may have occurred because of differences in acquiring them. Age and manner of acquisition seem to influence the way languages are stored in the brain. Hence, subsequent recanalization combined with revasculization that resulted in a decreased infarction area may affect the recovery of different language abilities to varying extents. This result is also consistent with ”Pitres'rule” and ”Ribot's law”. There are currently no standard bilingual aphasia tests available in Taiwan. Therefore, further research on the outcome for such patients after speech therapy is required and a modified Bilingual Aphasia Test for Taiwanese needs to be created.