ABSTRACT
The case of D, a 56-year-old postmaster with multiple language impairment following a left middle cerebral artery infarct, is discussed. Reputed to have been a great orator in his first language, Punjabi, he is also said to have been a fluent speaker of English. D presents now with severe fluent expressive dysphasia and a similarly severe auditory comprehension impairment. Written material is more readily understood, though unreliable and laboured beyond single words. He is largely dysgraphic demonstrating little success in written output beyond writing his own name. In the initial weeks of the current study, D also demonstrated a certain degree of cognitive inflexibility. In terms of physical disability following the stroke, D had a mild
right-sided weakness affecting upper limb function to a greater degree than lower limb. He was also reported to demonstrate some perceptual deficits affecting his ability to manipulate everyday objects, such as cutlery.
