交叉性失语(附5例病例分析)  

Crossed Aphasia:Discussing from Five Cases

作　　者：张玉梅[1] 周筠[1] 王丽敏[1] 王拥军[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经内科,北京市100054

出　　处：《中国卒中杂志》2006年第10期691-694,共4页Chinese Journal of Stroke

摘　　要：目的通过临床病例分析,回顾性探讨交叉性失语类型、可能的发生机制及预后。方法5例右利手右侧病变引起失语的患者均进行汉语失语成套测验中的口语流利性评定、西部失语评定及波士顿诊断性失语严重程度分级标准进行失语症严重程度分级,采用Frenchy构音障碍评定标准进行构音障碍评定;语言康复训练30d后,采用上述方法进行语言能力复查。结果5例病例均符合交叉性失语的诊断标准,经康复训练后,语言功能恢复较好。结论交叉性失语有两种类型:镜像失语及非典型失语,其可能的发生机制为:(1)右半球新的病灶使左半球处于静止或没有被发现的病灶,在某种程度上出现症状;(2)利手的同侧半球控制;(3)双侧半球均具有语言功能;(4)语言功能侧化停止于某一发展阶段。交叉性失语症预后好。Objective To analyze the type,mechanisms and prognosis of crossed aphasia by the clinical characteristics of five cases.Methods Five right～handed patients with aphasia due to acute stroke in the right hemisphere were studied by means of oral fiuent of aphasia battery of China,the western aphasia battery 、grade criterion of the boston diagnostic aphasia and Frenchy dysarthria battery.After rehabiliting language function for 30 d,these cases were studied by the same ways again.Results All five cases accorded with the diagnosis criterion of crossed aphasia,and got a well language function recovery by rehabilition.Conclusion Crossed aphasia has two types:mirror image aphasia and atypical crossed aphasia.Proposed mechanisms of crossed aphasia:(1)A previously silent or unrecognized lesion in the left hemisphere that is somehow rendered symptomatic by the new lesion in the right hemisphere;(2)Ipsilateral control of the dominant hand;(3)Bilateral representation of linguistic functions and(4)An arrested developmental stage in the lateralization of language function.Prognosis of crossed aphasia is better than other tgpes of aphasia.

关 键 词：交叉性失语 类型 发生机制 预后 

分 类 号：R741[医药卫生—神经病学与精神病学]