Language in the absence of inner speech

A 54-year-old man abruptly became mute with mild right hemiparesis. Written expression, comprehension of speech and print, calculating ability, and verbal short-term recall, although slow, were largely preserved. Extensive studies demonstrated complete loss of inner speech. He was unable to speak to himself and unable to appreciate the phonological structure of words. Instead, his preserved language skills were based on a highly developed visual imagery. This case greatly extends the range of language skills previously thought possible in individuals who suffer the loss of inner speech.