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Pure word deafness after bilateral primary auditory cortex infarcts

From the Department of Neurology (Drs. Coslett and Brashear), University of Virginia Hospital, Charlottesville, VA and Department of Neurology (Dr. Heilman), College of Medicine, University of Florida, and Veterans Administration Medical Center, Gainesville, FL.

In pure word deafness, comprehension and repetition of speech are impaired, but reading, writing, and spontaneous speech are preserved. Pure word deafness is distinguished from generalized auditory agnosia by the preserved ability to recognize environmental sounds. We examined a patient with pure word deafness associated with bilateral infarctions of the primary auditory cortex, who could use auditory affective intonation to enhance comprehension. The primary auditory cortex seems to be essential for comprehending speech, but comprehension of nonverbal sounds and affective prosody may be mediated by other cerebral structures such as the auditory association cortex.

Address correspondence and reprint requests to Dr. Coslett, Department of Neurology, Temple University Hospital, 3401 North Broad Street, Philadelphia, PA 19130.

Supported by the Medical Research Service of the Veterans Administration and by National Institutes of Health Grant No. NS-15229.

Accepted for publication June 29, 1983.

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