Aphemia associated with bilateral basal ganglia hemorrhage in a patient with chronic renal failure on maintenance hemodialysis

J Korean Neurol Assoc > Volume 16(6); 1998 > Article

Journal of the Korean Neurological Association 1998;16(6): 887-890.

혈액투석중인 만성 신부전증환자에서 양측 기저핵출혈 후 나타난 피질성 구음불능증

박만석, 이승한, 정슬기, 김명규, 조기현, 김세종

전남대학교 의과대학 신경과학교실

Aphemia associated with bilateral basal ganglia hemorrhage in a patient with chronic renal failure on maintenance hemodialysis

Man-seok Park, Seung-Han Lee, Xeul-Ki Cheong, Myeong-Kyu Kim, Ki-Hyun Cho, Sei-Jong Kim

Department of Neurology, College of Medicine Chonnam National University Hospital

Abstract

Aphemia, also called cortical anarthria, cortical dumbness or severe apraxia of speech, is a rare disorder of speech production, resulting from lesions affecting usually the inferior premotor cortex of the left hemisphere or, more rarely, bilateral basal ganglia. We report a 16-year-old right-handed male with chronic renal failure on maintenance hemodialysis. The patient exhibited clinical features typical of aphemia following bilateral basal ganglia hemorrhage. He initially presented with an isolated loss of the ability to articulate words without the loss of the ability to write or comprehend spoken language, and his brain MRI revealed bilateral basal ganglia hemorrhage. With the passage of time, initial mutism resolved into dysarthria with features similar to those seen in hypokinetic dysarthria. These clinical findings suggest a striato-capsular lesion is capable of producing temporary language disturbance. We report a case of aphemia associated with bilateral basal ganglia hemorrhage. Key words : aphemia, bilateral basal ganglia hemorrhage, chronic renal failure.