Aphasia is one of the most common
neurologic deficits occurring after
stroke. Although the speech-
language therapy is a mainstream option for poststroke
aphasia,
pharmacotherapy is recently being tried to modulate different
neurotransmitter systems. However, the efficacy of those treatments is still controversial. We present a case of a 53-year-old female patient with
Wernicke aphasia, after the old
infarction in the territory of left middle cerebral artery for 8 years and the recent
infarction in the right middle cerebral artery for 4 months. On the initial evaluation, the
Aphasia Quotient in Korean version of the Western
Aphasia Battery was 25.6 of 100. Baseline brain F-18 fluorodeoxyglucose positron emission tomographic images demonstrated a decreased cerebral metabolism in the left temporoparietal area and right temporal lobe.
Donepezil hydrochloride, a reversible
acetylcholinesterase inhibitor, was orally administered 5 mg/d for 6 weeks after the initial evaluation and was increased to 10 mg/d for the following 6 weeks. After the
donepezil treatment, the patient showed improvement in language function, scoring 51.0 of 100 on
Aphasia Quotient. A subtraction analysis of the brain F-18 fluorodeoxyglucose positron emission tomographic images after
donepezil medication demonstrated increased uptake in both middle temporal gyri, extended to the occipital area and the left cerebellum. Thus, we suggest that
donepezil can be an effective therapeutic choice for the treatment of
Wernicke aphasia.