Lexicalization in an anomic patient.

Following a haemorrhage in the left temporal lobe, a 25 yr-old left-handed male patient presented a word finding difficulty, particularly in confrontation naming. The patient had extensive semantic knowledge of the items that he was not able to name. Several experiments showed that he had a poor phonological image of the target word and was poorly helped by phonological cues. He had a better knowledge of the graphological image, but it remained insufficient to result in word retrieval. On several occasions, when the patient failed to name a picture which happened to be lexicalized by a polysemous word, a residual covert word form could still operate as a link between different meanings of the target word; then, the patient produces a word or a circumlocution related to one meaning which was not the illustrated meaning. This kind of response could be called a parasemia. We postulate that the patient's deficit took place outside semantic treatment and before achievement of lexical (phonological or graphological) output.