Wernicke's Aphasia

My preceptor and I took a trip to the ED last week to examine and admit a patient to the Neuro ICU.  I love going to the ED because you never know exactly what you're going to get.  Plus, it's usually chaotic and incredibly busy.

The patient was in the hospital 3 weeks earlier for an ischemic stroke of her temporal lobe and had since been discharged home.  She was sitting at the table when her son noticed that she was having difficulty speaking correctly.  The CT scan of her brain showed a hemorrhage into her old infarct.  Her blood pressure was sky high when she presented to the ED. 

What I found most interesting about this patient when I assessed her was her receptive aphasia.  In my experience, expressive aphasia is what I have seen most often.  Patients have an inability to express oneself or a lack of verbal expression.  Instead, this patient was talking a mile a minute with full facial expression and verbal inflection.  She was laughing after her sentences and seemed to just be enjoying every minute of our conversation.  The only problem was that she wasn't making any sense.  You could understand the words she said but none of the words together made sense.  Our conversation went something like this:

Me:"Can you tell me your name?"
Patient: "Oh, famous tell candy young did soccer eating horses in."  She would go on and on like this.  She was smiling, laughing and appeared to be having fun.

I had only ever read about Wernicke's aphasia in a textbooks or heard about it in class. Seeing a patient present with this type of receptive aphasia is something I won't forget for a very long time.

"Patients who recover from Wernicke’s aphasia report that, while aphasic, they found the speech of others to be unintelligible. And, despite being cognizant of the fact that they were speaking, they could neither stop themselves nor understand their own words." -citation unknown.