CROSSED APHASIA - NEW PERSPECTIVES

Crossed aphasia reflects an unusual lateralization pattern characterized by a dissociation between manual and language hemispheric dominance in a right-handed individual. In order to circumscribe the syndrome of crossed aphasia, authors have developed stringent exclusion criteria to define that syndrome. We believe that such an approach artificially created a homogeneous syndrome. As an alternative to the rigorous exclusion criteria approach, we propose to broaden the definition of crossed aphasia to accommodate the various demonstrated aphasic symptoms. The interest in crossed aphasia can then shift from the search for a universal symptom complex to different subgroups of patients. Indeed, there now appears to be overwhelming evidence (including Wada experiments) to indicate that crossed aphasia can either be the mirror image of uncrossed aphasia or indicate a bilateral language representation pattern. Two patients are presented and their symptoms arc discussed in the light of the literature. One of our patients is the only one to our knowledge to evidence affective prosody impairments. We argue that this latter symptom be added to the list of associated signs to be assessed as part of a crossed aphasia battery.