CLINICAL AND EXPERIMENTAL-STUDY OF AUDITORY AND SPEECH AGNOSIA (A CASE VERIFIED ANATOMICALLY AND HISTOLOGICALLY)

  • 1 January 1980
    • journal article
    • research article
    • Vol. 80  (12) , 1790-1798
Abstract
Under observation there was a female patient (a right-hander) who had 3 ischemic cerebral strokes within a year. After the 1st stroke she developed an amnestic-sensory aphasia, after the 2nd an auditory and speech agnosia with a complete loss of the ability to understand the speech addressed to her, and after the 3rd stroke she died. Macro- and microscopic examinations showed that the 1st stroke caused a destruction in the region of the left temporal lobe cortex involving a part of the Heschl convolution; the 2nd stroke resulted in destruction of the right temporal lobe involving almost the whole Heschl convolution. Thus the syndrome can develop only in case of a grave bitemporal damage. Comparative examinations of the speech and audition after the 1st and the 2nd stroke showed that in auditory and speech agnosia, the auditory discernment of phonemes, their combinations and the speech prosodic elements is pronouncingly deranged, the formation of conditioned reflexes to sounds of a supraliminal force is disturbed, the detection of short acoustic messages and acoustic filtration are hampered (mainly on the side contralateral to the affected one) the amusia gets more marked and the discernment of rhythms more difficult. All these disturbances are highly dynamic. A question on the role of defects of the right and the left hemispheres in the clinical picture of the auditory and speech agnosia is discussed.