右利者之交叉性失語症－病例報告

Neuropsychological Features of a Patient with Crossed Aphasia in Dextral

李苡星(Yi-Hsing Li) ； 花茂棽(Mau-Sun Hua) ； 湯頌君(Sung-Chun Tang) ； 鄭婷文(Ting-Wen Cheng) ； 陳至全(Chih-Chien Chen) ； 楊啟正(Chi-Cheng Yang)

《臨床心理學刊》 5卷2期 (2011/12) Pp. 64-71

https://doi.org/10.6550/ACP.201112_5(2).0005

摘要

目的：右利者之交叉性失語症（Crossed aphasia in dextral, CAD）發生率低，並且國內外研究對其神經認知功能表現仍未釐清。故本病例報告分析CAD病患的語言及其他認知功能表現，期能初步瞭解CAD病患的神經心理功能障礙。方法：本研究報告一位七十歲、慣用右手的男性病患，並於腦梗塞後評估其語言與其他神經認知功能表現。結果：病患具全面性失語症，且電腦斷層顯示右腦半球損傷。但由於無法排除病患左利手的家族史，故僅符合可能性CAD。病患亦有多方面的神經認知功能缺損，但部分功能可能受語言功能不佳的影響。結論：本研究所呈現的可能性CAD病患，在腦損傷區域與失語症間屬於鏡像型對應關係。此外，亦呈現建構失用症，可能與右側腦室周邊白質與豆狀核區域損傷有關。

關鍵字

交叉性失語症 ； 神經心理衡鑑 ； 語言功能

並列摘要

Objective: Crossed aphasia in dextral (CAD), a rare neuropsychological syndrome, usually caused by the cerebrovascular insults. Even though the past studies made efforts to identify the defective pattern of core linguistic functions in CAD patients, it is still unknown about the otherwise neurocognitive impairments which patients may also suffer from after CAD. Thus, this case-report study aims to preliminarily uncover a neuropsychological profile and to give a further understanding of the whole clinical characteristics of CAD. Methods: A 70-year-old male patient who underwent a comprehensive neurological, neuropsychological and neuroradiological examination after an infarction of the right-sided middle cerebral artery (MCA) territory. Results: Possible CAD is identified since this right-handed patient suffered from the global aphasia syndrome with a remarkable cerebrovascular insult over the right-sided MCA territory. In addition, a neuropsychological evaluation revealed the patient suffered from deficits of orientation, memory, executive function, visuoconstructive praxis and manual dexterity, and the former three were partially secondary to impairments in core linguistic function. Conclusion: This study might be the first one to present the whole neuropsychological features of CAD in Taiwan. Except for the patient's global aphasia syndrome, it is also important to identify the otherwise neurocognitive deficits, especially the constructional apraxia, in CAD patients who suffered from the right-sided MCA infarction.

並列關鍵字

crossed aphasia in dextral ； neuropsychological assessment ； core linguistic functions