Forgive me if I’m wrong here, the way I understood it was that the aphasia was caused because he hit his head quite nastily.
Also, I’m not a writer either but this episode pricked my interest and I did some research. I found that polyglots who suffer aphasia sometimes forget their mother tongue and start speaking in a language they learnt later. This would have been an interesting twist and a chance for House to show off since he is himself a polyglot if the patient had been multilingual as well. It would have made sense of the decoding part as well.

you said that the decode the aphasia thing was “ludicrous”
So i looked it up
cause i figured that its not to much of a long shot that this was possible

so i googled, used about 40 minuts and i came over this

http://books.google.no/books?id=0asXiTckqp0C&pg=PA71&lpg=PA71&dq=aphasia+nife+instead+of+spoon&source=bl&ots=DZJqehvVPl&sig=9yM2Ws54Om-LFfqweVurQfYMFJM&hl=no&ei=rMOwTaDpL5WW4gaIoIijDA&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBgQ6AEwAA#v=onepage&q&f=false

read the part that starts : When paitients says words that ryhmes with the correct……

i hope the link work, if not email me

i wanned to find out wether or not it is possible for a person with a serton type of aphesia to choose a word close in meaning as the word they wont like “spoon” instead of “Knife”
or by ryme like, as house use as an exaple “lable” instead of “table”

so my correction or your review is

it should in theory be possible to “decode the aphasia”

My email: Sigurdbergsvela@gmail.com
please Give me an answer, i would be delightet to hear wether i’m right or not

(I’m from norway and have dyslexia, please ignore the spilling errors)

The biggest mistake was that the MRI didn’t show any signs of infarction or hemorrhage. In cerebral malaria there’s occlusion of the small vessels causing microbleeds (as in vasculitis) and multiple infarctions. In the episode they only checked the T2 series, while they should’ve made DWI series and SWI.
On DWI, in respect to a clinical aphasia, there HAVE to be hyperintense lesions in the corresponding areas. On SWI you’d clearly see the microbleeds. When you’re thinking about recent infarction only T2 is obviously not enough.

As people mentioned before, the aphasia was of a strange type.
It was a typical wortsalat like in Wernicke, but the comprehension was completely intact.

Regarding this particular case, as with most of House’s cases, if this presentation exists at all, it is quite rare. As has been mentioned already, this type of fluent jargon production, particularly in the context of being unaware of one’s own errors, typically is accompanied by comprehension deficits. Language is an extremely complex integration of cognitive processes occurring in a parallel, interactive fashion. Many of the processes can be independently damaged, while sparing others, resulting in characteristic patterns of language performance. These patterns of performance have been classified by clinicians, and the most commonly recognized forms include Wernicke’s, Broca’s, Conduction, Anomic, Transcortical Sensory, Transcortical Motor, and Global aphasia. Wernicke’s and Broca’s aphasia, named for the neurologists who described the characteristic symptoms, were the first of these terms developed, and because of the stark contrast between them, these are the ones you may learn about in a Psych 101 class. In the real world however, the contrasts between diagnoses may not be quite so obvious.

These terms were developed about 100 years before clinical imaging (i.e. PET, CT, MRI) was available, using post-mortem dissection. The idea was to infer the location of brain damage from behavioral symptoms (e.g. Broca’s = anterior, Wernicke’s = posterior, Conduction = disconnection of anterior and posterior), and for the most part, these inferences work. The important thing to remember though is that these are syndromes, representing quite a bit of variability of symptom types and severity. For comparison, consider a patient with autism. This patient may fall anywhere along a spectrum of disorder, but the term itself carries a lot of useful stereotypical information. Many researchers in my field believe we should abandon the clinical terms for aphasia altogether, because they are often too imprecise for our purposes (e.g. localizing a single cognitive process). I disagree, because these terms provide a concise description for clinical purposes; nevertheless, one should be careful not to “pigeonhole” patients based on their diagnosis, especially since symptoms can vary over time through spontaneous recovery, or even over the course of a single day.

Overall, I thought it was a great episode, and I was happy to find such an interesting discussion about this topic.

But a Good episode also, House smooches ;-)

Not saying it is a bad episode though, I think it is hilarious.