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BMJ Case Rep. 2010; 2010: bcr07.2009.2062.
Published online 2010 February 8. doi:  10.1136/bcr.07.2009.2062
PMCID: PMC3029477
Reminder of important clinical lesson

Mother tongue lost while second language intact: insights into aphasia


Cortical representations of the native language and a second language may have different anatomical distribution. The relationships between the phonologic and orthographic forms of words continue to be debated. We present a bilingual patient whose competence in his mother tongue was disrupted following brain ischaemia. Semantic units were accessible only as isolated letters in written as well as oral language presentation. His second language appeared completely unaffected. Whole word system disturbance of both orthography and phonology pathways of the native language could explain this presentation. It is a great opportunity to learn about the language neural network when a bilingual subject presents with brain ischaemia.

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