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February 1988

Global Aphasia Without Other Lateralizing Signs

Arch Neurol. 1988;45(2):143. doi:10.1001/archneur.1988.00520260029015

To the Editor.  —Two recent articles have addressed the topographic correlates and the specificity of the syndrome of global aphasia without hemiparesis.1,2 Tranel et al1 confirmed the initial article by Van Horn and Hawes,3 because they found that this syndrome was related to two discrete ischemic lesions in the dominant hemisphere (one frontal, one temporoparietal), which were probably of embolic origin. On the other hand, other reports suggested that the syndrome can also be related to a single frontotemporoparietal lesion, which can sometimes be hemorrhagic.2,4 Unfortunately, this debate is confused by the fact that, although hemiparesis was said to be absent, ten of the 12 described patients had some degree of right-sided weakness or corticospinalComputed tomographic scan of left hemisphere showing single temporoparietal infarct. dysfunction (increased tendon reflexes, Babinski's sign), or other lateralizing signs (hemianopia). Global aphasia without other lateralizing signs was reported in only