Conduction Aphasia – Arcuate Fasciculus — SCE Neurology MCQ

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ModerateCerebrovascular DiseaseConduction Aphasia – Arcuate FasciculusSCE Neurology

A 60-year-old man with a right MCA stroke presents with fluent speech that is full of phonological errors (sound substitutions). He makes errors like saying 'tep' instead of 'step' and 'gat' instead of 'cat'. His comprehension is relatively preserved but repetition is impaired. What type of aphasia does he have?

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Correct answer: E — Conduction aphasia

Conduction aphasia is characterised by: fluent speech with phonemic (literal) paraphasias (sound substitutions — e.g. 'gat' for 'cat'), relatively preserved comprehension, but disproportionately impaired repetition. It results from damage to the arcuate fasciculus (the white matter pathway connecting Wernicke's and Broca's areas) or the supramarginal gyrus. Patients are often aware of their errors and attempt self-correction (conduite d'approche). A: Broca has non-fluent speech. B: Wernicke has impaired comprehension with semantic paraphasias. D: Transcortical motor has preserved repetition. E: Global impairs all language.

Reference: Clinical Neuroanatomy; RCP Stroke Guidelines