RESUMO
We report a right-handed patient with a massive lesion in left perisylvian language cortex, who unexpectedly presented with fluent aphasia with semantic jargon. Language deficits were assessed with a comprehensive battery of language tests. Comprehension, naming, reading, and writing were severely impaired, and verbal expression was moderately fluent with semantic jargon. Although the patient's lesion included brain areas typically essential for motor speech coordination, he was neither nonfluent nor apraxic. He exhibited strikingly unexpected aphasia with semantic jargon and prominent comprehension deficits, suggesting that this is a case of mixed dominance: the right hemisphere likely controls motor speech and basic syntactic skills, while the severely damaged left hemisphere controls semantic processing, predictably severely impaired.
Assuntos
Afasia/etiologia , Afasia/patologia , Lateralidade Funcional/fisiologia , Deficiência Intelectual/complicações , Malformações do Desenvolvimento Cortical/complicações , Semântica , Anormalidades Múltiplas , Afasia/diagnóstico por imagem , Humanos , Testes de Linguagem , Masculino , Pessoa de Meia-Idade , Tomógrafos ComputadorizadosRESUMO
A variety of social, political, and economic factors influenced the creation of the first Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1952. Subsequent to DSM-I, cultural, medical, and economic factors shaped each successive version of the DSM; we discuss some of the more prominent controversies these editions have generated. Publication of the DSM-5 in May 2013 sparked a new round of debates concerning the possible impact on patients and society as a whole.
Uma variedade de fatores políticos e econômicos influenciou a criação do primeiro Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM), em 1952. Após o DSM-I, fatores culturais, médicos e econômicos formataram as versões sucessivas do DSM; discutimos algumas das mais prominentes controvérsias geradas por essas edições. A publicação do DSM-5, em maio de 2013, levantou um novo ciclo de debates relativos ao possível impacto nos pacientes e na sociedade como um todo.