Want to re-read the case before checking out the answer? See it here
The Answer
This patient is presenting with a physical exam finding consisting of fluent sounding speech that is meaningless. What is this physical exam finding called?
Back To Fun Med School Pathophys
Two centers of language are Broca’s area and Wernicke’s area.
To put it simply, Wernicke’s is responsible for organizing speech into a coherent product while Broca’s is involved in the physical act of producing speech.
Damage to Broca's would therefore result in?
Damage to Wernicke's would lead to?
Patients with injuries to these areas may present with no other neurologic deficits or symptoms at all!
Diff Dx
The differential includes any disease process that could damage Wernicke’s area only:Â neoplasm (+/- hemorrage), CVA (ischemic and hemorrhagic), cerebral abscess, encephalitis, trauma, MS (uncommon).
Testing/Dispo
Head CT with resulting neuro/neurosx consult and admit.
Here’s a lesion that could present like the above. On CT here it actually looks like an ischemic CVA.
But ended up being a low grade glioma on MRI.
By Dr. Andrew Grock
 References
Stephen G. Waxman, Clinical Neuroanatomy, 27e
Allan H. Ropper, Martin A. Samuels, Adams and Victor’s Principles of Neurology, 10e
Harrison’s 18th edition
Neurology 4th ed, thieme
uptodate.com
andygrock
Latest posts by andygrock (see all)
- Levamisole Toxicity - May 26, 2015
- Of Course, US Only for Kidney Stones… - May 18, 2015
- Case of the Month 11: Answer - May 12, 2015
0 Comments