Sapir, Shimon

A 74-year-old, right-handed woman suffered acute aphasia and left hemiplegia secondary to a cerebral infarction in the right cerebral hemisphere. The lesion was located deep in the parietal lobe and extended to the posterior limb of the internal capsule and the head of the caudate nucleus. The patient's aphasia was characterized by severe impairment in auditory and visual comprehension and auditory retention span, as well as by anomia, agraphia, and dyscalculia. She showed rapid recovery from her aphasia, with residual deficits in writing, naming, calculation, and memory.

Depression, anxiety, and conversion reaction are common in neurologic patients. These disorders can produce neurologic-like symptoms that either mask or intensify those produced by the neurologic disease. This paper reviews clinical and research findings relating psychopathology to the formation and remediation of speech and language disorders in neurologic patients. The need to consider the psychosocial and psychopathological aspects of neurologic communicative disorders, and the link between emotional and communicative processes, are emphasized. Diagnostic criteria for the identification of psychogenic communicative disorders are outlined.