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A Disconnection Syndrome

Mario F. Mendez, MD; D. Frank Benson, MD

Arch Neurol. 1985;42(9):886-891.

Abstract
• Conduction aphasia was originally proposed to result from separation of the posterior language comprehension area and the anterior motor speech area of the left hemisphere. The arcuate fasciculus has been the most frequently suggested site of such a disconnection, but the syndrome has been reported in cases in which the abnormality involved the dominant Wernicke's area. This challenges the arcuate fasciculus theory, and it has been suggested that a cortical lesion, not a disconnection, is the crucial factor. Three new cases in which the lesion does not lie in the arcuate fasciculus are reported, two in left-handed patients with left temporoparietal lesions and one in a righthanded patient with a right temporoparietal infarct, a "crossed" aphasia. While atypical, these cases offer evidence that disconnection of the circuit linking language comprehension to motor speech output, not damage to a specific cortical region, underlies the syndrome of conduction aphasia.

Author Affiliations
From the Department of Neurology, UCLA School of Medicine, Los Angeles. Dr Méndez is now with the Veterans Administration Medical Center, Providence, RI.

Footnotes
Accepted for publication Aug 30, 1984.

Read in part before the 35th annual meeting of the American Academy of Neurology, San Diego, April 27, 1983.

Reprint requests to Neurology Service, Veterans Administration Medical Center, Providence, RI 02908 (Dr Méndez).

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