Buchman A S, Garron D C, Trost-Cardamone J E, Wichter M D, Schwartz M
J Neurol Neurosurg Psychiatry. 1986 May;49(5):489-99. doi: 10.1136/jnnp.49.5.489.
Since its original description the diagnosis of word deafness has been greatly expanded. Confusion has arisen with regard to the usage of the related terms pure word deafness, auditory agnosia, and cortical deafness. Three new cases of word deafness are presented including one case with CT and necropsy correlation. These cases are compared with 34 previously reported cases of various cortical auditory disorders. Our review establishes that patients with word deafness who have had formal testing of linguistic and non-linguistic sound comprehension and musical abilities always demonstrated a more pervasive auditory agnosia. Despite the spectrum of auditory deficits and associated language abnormalities, patients with word deafness share common features including aetiology, pathology, clinical presentation and course. These common features justify inclusion of heterogeneous cortical auditory disorders under the rubric of word deafness. Despite some limitations the term "word deafness" should be retained for this syndrome, since inability to comprehend spoken words is the most distinctive clinical deficit. Word deafness is most frequently caused by cerebrovascular accidents of presumed cardiac embolisation, with bitemporal cortico-subcortical lesions. The sequence of cerebral injury is not predictive of resulting auditory deficits. Impairment of musical abilities parallels the severity of the auditory disorder.
自从最初对词聋进行描述以来，词聋的诊断范围已大幅扩展。在相关术语纯词聋、听觉失认症和皮质聋的使用方面出现了混淆。本文报告了3例新词聋病例，其中1例有CT及尸检结果对照。将这些病例与之前报道的34例各种皮质听觉障碍病例进行了比较。我们的综述表明，对语言和非语言声音理解以及音乐能力进行过正式测试的词聋患者总是表现出更广泛的听觉失认症。尽管存在一系列听觉缺陷及相关的语言异常，但词聋患者具有包括病因、病理、临床表现及病程等方面的共同特征。这些共同特征证明将各种皮质听觉障碍归为词聋范畴是合理的。尽管存在一些局限性，但“词聋”这一术语仍应保留用于该综合征，因为无法理解口语单词是最显著的临床缺陷。词聋最常见的病因是推测为心源性栓塞的脑血管意外，病变位于双侧颞叶皮质 - 皮质下区域。脑损伤的顺序并不能预测所导致的听觉缺陷。音乐能力受损程度与听觉障碍的严重程度平行。
