Malapropism in Wernicke’s aphasia

Patient interview with spouse after follow-up on April 10, 2017.

The initial neurological manifestation in this patient was from infarction of Wernicke’s area, resulting in a mild form of Wernicke’s aphasia, where the person uses grammatically correct sentences with normal rate and prosody, but substitutes wrong, non-existent, or irrelevant words. A feature of mild Wernicke’s aphasia is phonemic paraphasia, whereby, trying to find the right word, the person substitutes a word or non-word that preserves at least half of the segments or number of syllables of the intended word. Although the result might be amusing to others, it is called malapropism. According to the American philosopher Donald Davidson, malapropism attests to the complex process the brain uses to translate thoughts into language. As is characteristic of Wernicke’s aphasia, this patient’s motor function, intellectual and cognitive capabilities unrelated to speech and language were preserved to start with. In her case, comprehension and writing, which are usually affected in Wernicke’s aphasia, were also intact to begin with, suggesting that the first infarct was very limited, as she could produce the legal documents needed for her work to a high standard. As is typical of Wernicke’s aphasia, the patient did not realise that she was using the wrong words or using non-existent words. Her family was amused and bewildered. This patient’s language skills provided credibility in her work, so the neurological effects, albeit amusing for others, were profoundly consequential for her.

Published: September 2, 2017