Habib M, Daquin G, Milandre L, Royere M L, Rey M, Lanteri A, Salamon G, Khalil R
Department of Neurology, University Hospital of Marseilles, France.
Neuropsychologia. 1995 Mar;33(3):327-39. doi: 10.1016/0028-3932(94)00108-2.
We report a case of transient mutism and persistent auditory agnosia due to two successive ischemic infarcts mainly involving the insular cortex on both hemispheres. During the 'mutic' period, which lasted about 1 month, the patient did not respond to any auditory stimuli and made no effort to communicate. On follow-up examinations, language competences had re-appeared almost intact, but a massive auditory agnosia for non-verbal sounds was observed. From close inspection of lesion site, as determined with brain resonance imaging, and from a study of auditory evoked potentials, it is concluded that bilateral insular damage was crucial to both expressive and receptive components of the syndrome. The role of the insula in verbal and non-verbal communication is discussed in the light of anatomical descriptions of the pattern of connectivity of the insular cortex.
我们报告一例因两次连续的缺血性梗死导致短暂性缄默症和持续性听觉失认症的病例，梗死主要累及双侧岛叶皮质。在持续约1个月的“缄默期”，患者对任何听觉刺激均无反应，也不主动交流。在后续检查中，语言能力几乎完全恢复，但观察到对非言语声音存在严重的听觉失认。通过脑磁共振成像确定的病变部位仔细检查以及听觉诱发电位研究得出结论，双侧岛叶损伤对该综合征的表达和接受成分均至关重要。根据岛叶皮质连接模式的解剖学描述，讨论了岛叶在言语和非言语交流中的作用。
