Wernicke aphasia (Receptive aphasia): Signs, symptoms and causes

2021-07-23 09:43 AM

Wernicke aphasia is caused by posterior gyrus damage to the temporal lobe of the dominant hemisphere. This area is supplied with blood by branches of the middle cerebral artery. 

Description

Receptive aphasia is a disorder related to language comprehension. Speech fluency is usually unaffected. The patient's language is completely meaningless or unusual and may have dysarthria (in other words, using language that doesn't fit the context or logic).

Neurosurgery and regional anatomy: Wernicke area - posterior gyrus on temporal lobe, dominant cerebral hemisphere ⇒ Inferior middle cerebral artery.

Causes

Often met

Middle cerebral artery infarction.

Brain hemorrhage.

Vascular dementia.

Migraine (transient).

Less common

Alzheimer.

Massive lesions (eg, tumor, mass, arteriovenous fistula).

Primary progressive aphasia.

Wernicke's area, posterior gyrus on the temporal lobe, dominant hemisphere

Figure: Wernicke's area, posterior gyrus on the temporal lobe, dominant hemisphere.

 

MRI of a patient with Wernicke aphasia caused by damage to the temporal lobe. 

Figure: MRI of a patient with Wernicke aphasia caused by damage to the temporal lobe. 

A: Cross-sectional; B: Cropped vertically.

Mechanism

Wernicke aphasia is caused by posterior gyrus damage to the temporal lobe of the dominant hemisphere. This area is supplied by branches of the middle cerebral artery. The most common cause is cerebral infarction in the inferior middle cerebral artery. Patients with a dominant hand (left or right) will correspond to the dominant cerebral hemisphere, so it is valuable in the localization of the lesion. More extensive lesions may affect movement and sensory centers and/or the optic tract, leading to symptoms of contralateral movement and sensory disturbances, and contralateral hemiparesis contralateral aphasia is a common finding in Wernicke's aphasia (receptive aphasia), where movement and sensory disturbances are more common than Broca's aphasia (expressive aphasia). Refer to Wernicke's Table of Symptoms of Aphasia.

Clinical features

 

Wernicke's aphasia abnormalities

Automatic language

 

Fluency, same as the language disorder. Lisp is unusual.

Calling name

 

Disorder (often misnomer)

Understanding   Disorder
Repeat   Disorder
Reading   Disorder of understanding and loudly speaking.
Writting  

Well writing, in paragraphs.

Accompanying signs

 

Less common contralateral movement and sensory signs.

Figure: Clinical features of Wernicke's aphasia

Significance

Wernicke's aphasia or receptive aphasia is a focal finding in the dominant cortex. Acute aphasia may initially be considered a sign of stroke until further evidence is available.