Lebrun Y
Cortex. 1987 Jun;23(2):251-63. doi: 10.1016/s0010-9452(87)80035-7.
The notion that aphasia may be accompanied by some degree of unawareness of the disorder was introduced by Wernicke in 1874. Ever since the idea has prevailed that sensory aphasics, especially jargonaphasics, are not, or but little, conscious of their deviant verbal output. This view was disputed in recent years. It was claimed that anosognosia was not a typical feature of Wernicke's aphasia or of jargonaphasia. However, analysis of the behavior of sensory aphasics shows that some of these patients are not well aware of the deviances in their verbal output. This unawareness may be due to verbal deafness or to disturbed feedback. On the other hand, some aphasics appear to realize that their verbal expression is anomalous but choose to ignore the fact in order to preserve their self-image or to keep up the social intercourse with the environment. Anosognosia can be found in association not only with sensory aphasia but also with monophasia and with modality-specific aphasia, as well as with unilateral neglect and with apraxia. If a patient has anosognosia, the speech therapist must know about it and take it into account, lest it renders therapeutical efforts fruitless.
失语症可能伴有某种程度的对该病症无意识的观念是由韦尼克于1874年提出的。自那时起，一种观点盛行起来，即感觉性失语症患者，尤其是杂乱性失语症患者，对其异常的言语输出没有意识或仅有很少的意识。近年来，这一观点受到了质疑。有人声称，疾病失认症并非韦尼克失语症或杂乱性失语症的典型特征。然而，对感觉性失语症患者行为的分析表明，其中一些患者并未充分意识到其言语输出中的偏差。这种无意识可能是由于听觉性失语或反馈障碍所致。另一方面，一些失语症患者似乎意识到他们的言语表达是异常的，但为了维护自我形象或保持与周围环境的社交互动而选择忽略这一事实。疾病失认症不仅可能与感觉性失语症相关，还可能与单语症、特定模态失语症相关，以及与单侧忽视和失用症相关。如果患者患有疾病失认症，言语治疗师必须了解这一点并加以考虑，以免治疗努力徒劳无功。
