Evidence for multiple routes of speech production in a case of fluent aphasia

A case study is reported of a 24-year old woman who developed fluent aphasia with superior reading relative to auditory comprehension following herpes simplex encephalitis. Her language disturbance showed exceptional features: oral reading, repetition and naming to confrontation were severely impaired and yet her spontaneous speech recovered to be relatively intact. These features are not consistent with Wernicke's aphasia, pure word deafness or any classic aphasic syndromes. These findings indicate the presence of several routes for phonological output that may be differentially impaired.