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22 - Acquired disorders of language

from PART II - DISORDERS OF HIGHER FUNCTION

Published online by Cambridge University Press:  05 August 2016

John Hart
Affiliation:
Laboratory of Cognition and Brain Imaging, Donald W. Reynolds Center on Aging, Unversity of Arkansas Medical School, USA
Ola A. Selnes
Affiliation:
Department of Neurology, School of Medicine and Department of Cognitive Science, Krieger Mind/Brain Institute, The Johns Hopkins University, MD, USA
Arthur K. Asbury
Affiliation:
University of Pennsylvania School of Medicine
Guy M. McKhann
Affiliation:
The Johns Hopkins University School of Medicine
W. Ian McDonald
Affiliation:
University College London
Peter J. Goadsby
Affiliation:
University College London
Justin C. McArthur
Affiliation:
The Johns Hopkins University School of Medicine
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Summary

In 1915, the British neurologist Henry Head commented on recent developments in clinical aphasiology and concluded that: ‘It is generally conceded that the views on aphasia and analogous disturbances of speech found in the textbooks of today are of little help in understanding an actual case of disease’ (Head, 1915). This may still be true to a certain extent, although perhaps for different reasons from those that Head had in mind. Most textbooks typically describe classical aphasia syndromes that are based on chronic, stable patients; thus by definition different from the patient with acute symptoms that the neurologist typically encounters. It has been estimated that only 20–30% of all patients with aphasia will fit neatly into one of the classical aphasia syndromes (Albert et al., 1991). Nonetheless, the clinical use of the classical syndrome classification as a basis for diagnosis has continued more or less unchanged.

The convenience of this approach in clinical settings notwithstanding, increasing dissatisfaction with the classical taxonomy of aphasia has been expressed by researchers in the field of aphasia, in particular psycholinguistics and cognitive psychologists (Schwartz, 1984). The principal concern is that the classical model does not necessarily generate any meaningful generalizations about the nature of brain-language relationships. Some have argued that the classical aphasia syndromes do not meet standard criteria for a syndrome, in that none of the syndromes can be characterized in terms of invariant features that are shared by all patients given a certain classification and are absent in patients with a different classification (Caramazza, 1984). Classical taxonomy can thus best be characterized as polytypic, implying that any given feature or impairment, for example phonological paraphasias, can be part of more than one syndrome (Schwartz, 1984).

Despite the controversy over classical aphasia taxonomy in research settings and the limited number of aphasic patients it accounts for, the clinical utility of classic aphasia syndromes has rarely been questioned. It appears to have been assumed that the syndromes are associated with a certain degree of anatomical predictability, which may allow the clinician to infer lesion location, etiology, and prognosis (Albert et al., 1991). Recent studies have questioned the validity of these assumptions, however.

Type
Chapter
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Diseases of the Nervous System
Clinical Neuroscience and Therapeutic Principles
, pp. 317 - 330
Publisher: Cambridge University Press
Print publication year: 2002

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  • Acquired disorders of language
    • By John Hart, Laboratory of Cognition and Brain Imaging, Donald W. Reynolds Center on Aging, Unversity of Arkansas Medical School, USA, Ola A. Selnes, Department of Neurology, School of Medicine and Department of Cognitive Science, Krieger Mind/Brain Institute, The Johns Hopkins University, MD, USA
  • Edited by Arthur K. Asbury, University of Pennsylvania School of Medicine, Guy M. McKhann, The Johns Hopkins University School of Medicine, W. Ian McDonald, University College London, Peter J. Goadsby, University College London, Justin C. McArthur, The Johns Hopkins University School of Medicine
  • Book: Diseases of the Nervous System
  • Online publication: 05 August 2016
  • Chapter DOI: https://doi.org/10.1017/CBO9781316134993.023
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  • Acquired disorders of language
    • By John Hart, Laboratory of Cognition and Brain Imaging, Donald W. Reynolds Center on Aging, Unversity of Arkansas Medical School, USA, Ola A. Selnes, Department of Neurology, School of Medicine and Department of Cognitive Science, Krieger Mind/Brain Institute, The Johns Hopkins University, MD, USA
  • Edited by Arthur K. Asbury, University of Pennsylvania School of Medicine, Guy M. McKhann, The Johns Hopkins University School of Medicine, W. Ian McDonald, University College London, Peter J. Goadsby, University College London, Justin C. McArthur, The Johns Hopkins University School of Medicine
  • Book: Diseases of the Nervous System
  • Online publication: 05 August 2016
  • Chapter DOI: https://doi.org/10.1017/CBO9781316134993.023
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Acquired disorders of language
    • By John Hart, Laboratory of Cognition and Brain Imaging, Donald W. Reynolds Center on Aging, Unversity of Arkansas Medical School, USA, Ola A. Selnes, Department of Neurology, School of Medicine and Department of Cognitive Science, Krieger Mind/Brain Institute, The Johns Hopkins University, MD, USA
  • Edited by Arthur K. Asbury, University of Pennsylvania School of Medicine, Guy M. McKhann, The Johns Hopkins University School of Medicine, W. Ian McDonald, University College London, Peter J. Goadsby, University College London, Justin C. McArthur, The Johns Hopkins University School of Medicine
  • Book: Diseases of the Nervous System
  • Online publication: 05 August 2016
  • Chapter DOI: https://doi.org/10.1017/CBO9781316134993.023
Available formats
×