Neurolinguistic Aspects of Bilingual Thalamic Aphasia. A Clinical Case

Abstract

The case of a right-handed young male (R.P.) with English as Ll and Italian as L2 is reported. At the age of 28 he suffered a stroke which brought about an ischemic lesion to the left thalamus and the splenium. R.P. presented with mutism, reduced strength and right-sided paralysis. The patient slowly recovered language but exhibited bilingual aphasia. After the stroke his IQ was in the normal range. His verbal short-term memory span for disyllabic words was reduced. His verbal long-term memory was greatly impaired and he was severely disoriented in time and space. R.P. showed poor verbal initiative, and in both languages he had severe word-finding difficulties, made many repetitions, some phonemic paraphasias and omissions of bound grammar morphemes. On the Bilingual Aphasia Test the most severely compromised linguistic levels were morphology, semantics and syntax. Furthermore, the patient showed considerable difficulty to translate sentences in both directions. This case seems to confirm that language functions are represented in the left subcortical structures (thalamus). As R.P. showed parallel recovery of Ll and L2, it may be suggested that the two languages are equally and similarly represented in the left thalamus.

Keywords

• subcortical aphasia
• bilingualism
• memory disorders
• left thalamus