Prof. Dr. Kemal Arıkan
Psikiyatrist

Wernicke’s Aphasia

When there is a lesion in the Wernicke area, the images and words transmitted to the visual and auditory cortices cannot stimulate this area, therefore fails to activate the language system. The patient cannot process this information within the context of language, thus cannot understand the speech s/he hears or read the writing s/he sees.

Patients with Wernicke’s aphasia are not aware of this situation. They speak fluently. They speak non-stop. The number of words they say in a minute is normal, or even beyond normal. The patients cannot recognize that they have speech disorder. In general, the patients think they express what they want to say and might get angry when they are not understood. Words coming out of their mouth are incomprehensible.

They make 2 different types of paraphasia:

Verbal paraphasia; they mistake one word for another. For instance, the patient might say “I like you” while actually meaning “come here”.

Examples of speech of a patient attempting to talk with verbal paraphasia:

– “What’s your name?”

Answer: “I understand, they are nice but I cannot buy. I accept it but I cannot buy.”

– “How are you?”

Answer: “I simply cannot buy; these waiting I’ve been”

When shown a key and asked what that was, the patient recognized the key and said “This is what we cheat on, women wait such things” instead of saying “key” while making gestures like turning a key and opening a door. During the assessment of Wernicke’s Aphasia, the same patient was shown a Cookie card. This card has an image of a woman washing dishes as the water is overflowing through the floor; a girl and a boy steal cookies from a jar behind the woman; the stool the boy got on tips over. When asked to tell what he sees on that card, the patient’s answer was “There is a girl, as a woman here, I mean this girl didn’t do these, caused by the boy.”

Neo-logistic paraphasia: they speak in a new language where they juxtapose irrelevant syllables. They speak in an extremely jerky manner. They may also have perseveration during the speech. “The kid’s place in this home was entered. This kid’s checkered plane, went in. The woman, they bought the small newly-opened place, came in with the kid while falling. The kid’s seizure was fall down. Fallen seizure to the frol. It was let fall with tips. For your daughter the place was dropped. Ceekor”

Examples from two patients speaking with paraphasia used for the assessment of their neo-logistic Wernicke’s aphasia:

The patient, who was shown a Cookie card and asked to tell what he saw, said: “These two inside shell. This is for felg. This from gıbl. On the other hand, sılıs case, cubıla to his nape”. When shown a pencil and a table, and asked about their names, this patient said “Hambe”, and “Faze”. For the same card, the second patient said: “Sandıl, camadan cigen, trees Woman dress tight. Thghts dress.”

The patients with Wernicke’s aphasia have impaired comprehension. They understand neither what they say, nor what is said to them. However, they understand mimics and gestures. As they don’t understand what is said to them, they cannot repeat it. They have an advanced level of naming the things they see, but their reading and writing are impaired at a normal level. Like the patients with Broca’s aphasia, they cannot perform mathematical operations.

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