Crossed aphasia in early childhood.

A four-year-old child was admitted to hospital with an infarct of the right middle cerebral artery involving the frontoparietal area. His symptoms included left hemiplegia and aphasia. After two weeks, he had hemiparesis, word-finding and naming problems and enuresis. A year later he demonstrated elective mutism at school, had attention and short-term memory impairments, occasional enuresis and an average IQ. He was shy and withdrawn; this is interesting, since depression is usually associated with left-hemispheric lesions. It is suggested that an early period of mutism should be included among the criteria for the study of crossed aphasia in children, as this is a common occurrence in such cases. Even after recovery of speech, impairments in attention and academic skills may persist.