Say What?

February 24, 2008 at 8:44 pm (Uncategorized)

    At the risk of admitting the extent to which I devour pop culture, the first time I was introduced to the concept of aphasia was during an episode of House.  The patient on the episode spoke rambled nonsense and was diagnosed with Wernicke’s Aphasia (speaking illogical sentences) and Agraphia (the inability to write rationally).  Being the omnipotent doctor that House is, he was able to replace the illogical words for what the patient meant to say and found a way to communicate.  While I am ignorant enough to believe a lot of the show (and the consequent hundreds of thousands of dollars in MRI’s) as plausible, I needed to investigate this peculiar neurological disorder for myself.

After reading about Wernicke’s (or ‘receptive’) Aphasia, I found that many of the references in the episode were accurate.  The disorder is often caused by a lesion or damage in Wernicke’s Area (Brodman Area 22) and has a profound effect if presented in the dominant hemisphere.  If it the lesion is in the non-dominant hemisphere the aphasia only effects the ability to perceive pitch, rhythm, and emotion in speech.   Thus, Wernicke’s Aphasia is characterized by the inability to understand words.  Unlike Broca’s Aphasia, where the patient has difficulty producing speech, patients with Wernicke’s Aphasia can not understand speech/language but speak fluently and as if they are making sense.

Patients with Wernicke’s demonstrate how crucial the process of auditory feedback is communication.  Similar to the case of deaf people, where they can not hear what they are saying and correct the phonetics of their speech, Wernicke’s patients cannot correct the actual words they use.  One example used when describing this disease is the inability to perceive the difference between words such as “bed” and “bad”.  Using this example it is easy to see how much of their vocabulary could be skewed, resulting in their ‘word salad’.   In the episode House interprets what the patient is saying and translates it into correct speech (one example was the word “bear” to “polar bear” to “bi-polar disorder”).  While the words are somewhat logically connected, the word “bear” and “bi-polar disorder” are not phonetically similar, which is believed to be the basis of Wernicke’s.  Thus, this scenario is a little absurd, and not exactly how a patient with Wernicke’s would replace words, but who am I to argue with House?