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A woman with language disturbance
  1. B Menon,
  2. B Vengamma
  1. Sri Venkateswara Institute of Medical Science, Tirupati, India
  1. Correspondence to:
 Dr B Menon
 Department of Neurology, Sri Venkateswara Institute of Medical Science, Tirupati, Andhra Pradesh, India 517507; bindumenon_2003yahoo.com

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Answers on page 342.

A 42 old year right handed woman presented to the emergency services with sudden onset of weakness of the left upper and lower limbs with inability to speak in the past 24 hours. She had type 2 diabetes mellitus for the past five years and was normotensive. Her birth and developmental history was normal. She had studied until 10th standard (12 years of education) and spoke only her mother tongue. She did not have any childhood brain damage. General examination was normal. She was conscious and had a non-fluent aphasia with impaired comprehension and intact repetition. She was unable to read and write. She had Medical Research Council (MRC) grading 4 + weakness on her left upper and lower limbs. Plantar response was extensor on the left side. Her haemogram and renal function tests were normal. Her fasting and postprandial plasma glucose was 7.2 mmol/l and 11.7 mmol/l respectively. Her lipid profile showed hypertriglyceridaemia (7.7 g/l) and hypercholesterolemia (2.2 g/l). Figure 1 shows the computed tomogram of the head at admission.

Figure 1

 Computed tomogram shows infarct in the right posterior parietal area.

QUESTIONS

  1. What does the patient’s computed tomogram show?

  2. What is her language dysfunction?

  3. How can her language dysfunction be explained on the basis of the computed tomogram?

  4. What would be the recovery profile of this patient?

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