title: Pathophysiology of language switching and mixing in an early bilingual child with subcortical aphasia.
abstract: Acquired aphasia after circumscribed vascular subcortical lesions has not been reported in bilingual children. We report clinical and neuroimaging findings in an early bilingual boy who incurred equally severe transcortical sensory aphasia in his first language (L1) and second language (L2) after a posterior left thalamic hemorrhage. Following recurrent bleeding of the lesion the aphasic symptoms substantially aggravated. Spontaneous pathological language switching and mixing were found in both languages. Remission of these phenomena was reflected on brain perfusion SPECT revealing improved perfusion in the left frontal lobe and left caudate nucleus. The parallelism between the evolution of language symptoms and the SPECT findings may demonstrate that a subcortical left frontal lobe circuity is crucially involved in language switching and mixing.
authors.affiliation: Department of Neurology, General Hospital Middelheim, Antwerp, Belgium. petermarien@skynet.be
authors.forename: Peter
authors.initials: P
authors.lastname: Mariën
authors.forename: Jubin
authors.initials: J
authors.lastname: Abutalebi
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Engelborghs
authors.forename: Peter P
authors.initials: PP
authors.lastname: De Deyn
mesh_terms: D000293:Adolescent; D001041:Aphasia, Wernicke / Q000145:classification / Q000209:etiology* / Q000628:therapy; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D002421:Caudate Nucleus / Q000473:pathology / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D002648:Child; D005625:Frontal Lobe / Q000473:pathology* / Q000503:physiopathology; D007839:Functional Laterality; D006801:Humans; D007808:Language Therapy; D008297:Male; D019303:Multilingualism; D009483:Neuropsychological Tests; D012008:Recurrence; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D013788:Thalamus / Q000473:pathology / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D014825:Vocabulary