title: [How to examine a patient with higher cerebral dysfunction].
abstract: The mysterious maneuvers of the neuropsychological examination actually conceal the very intellectual process by which diagnosis is obtained. Five features that are usually sufficient to diagnose aphasia are 1) spontaneous speech, 2) speech comprehension, 3) repetition, 4) reading aloud with comprehension, and 5) writing. In spontaneous speech, fluent aphasics have normal rhythm, melody, and well-articulated sentence, but the speech is filled with paraphasias. The speech of non-fluent aphasics is slow, labored, and poorly articulated. When patients with spatial neglect are asked to perform a variety of tasks in space, they neglect the hemispace contralateral to their lesion. For example, when asked to draw a picture of a flower, they may draw only a half of the flower. The patients may fail to cross out lines distributed over a page. Amnesic patients, despite normal scores on psychometric tests of intelligence and normal performances on immediate memory, show significant impairments in new learning (anterograde amnesia) and remote memory (retrograde amnesia). In this article, The author also explained about two topics briefly of language functions (tactile reading) and hemispatial neglect (reference frames).
authors.affiliation: Department of Neurology, Japanese Red Cross Medical Center.
authors.forename: K
authors.initials: K
authors.lastname: Takeda
mesh_terms: D000647:Amnesia / Q000175:diagnosis*; D001037:Aphasia / Q000175:diagnosis*; D006801:Humans; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging; D010468:Perceptual Disorders / Q000175:diagnosis*