Wernicke's aphasia is characterized by which of the following?

• A. Expressive language impairment with nonfluent, effortful speech.
• B. Global aphasia
• C. Receptive language impairment with fluent, effortless speech that is out of context.
• D. Dementia

Answer: (C)

Wernicke's aphasia is a receptive language disturbance in which understanding spoken language is impaired, yet speech remains fluent and effortless. The hallmark is fluent, well-formed-sounding speech that carries little meaningful content because comprehension is lost. Patients often use correct-sounding words but produce them inappropriately (paraphasias) or invent new words (neologisms), and they may not realize their mistakes. Repetition is also impaired due to the underlying comprehension deficit. This pattern fits the description of receptive language impairment with fluent, effortless speech that is out of context.

The other patterns don’t fit as well: there, speech is nonfluent and effortful with good comprehension in Broca’s area damage; global aphasia would show widespread impairment of both expression and comprehension; and dementia is a progressive, generalized decline rather than a focal language syndrome.