Aphasia

Aphasia - total or partial loss of speech, caused by defeat of the speech centres of the brain cortex or their pathways at the safety features of speech muscles (tongue, lips, throat). Aphasia occurs when hemorrhages in the brain, thrombosis of vessels of the brain abscesses, traumatic brain injuries , etc. Aphasia often accompanied by a reading disorder - Alexia, letters - agraphia, account - acalculia. Depending on the affected area developing various forms of aphasia.
Motor aphasia is characterized by difficulty or inability to pronounce words when saving the pronunciation of individual sounds and speech understanding. When the most severe motor aphasia it is completely absent. In these cases, even after the restoration of speech in a patient remain difficulties in complex statements, by repeating a series of words (house, forest, cat)phrase.
Sensory aphasia is characterized by a violation of the understanding of speech (verbal deafness) while maintaining the ability to speak. In mild cases the patient has understood the individual words and even phrases, especially the usual ("open mouth", "display language"). In contrast to patients with motor aphasia these patients are talkative, but because they do not understand their words, they lose control of his tongue, and she also violated appear replacement of letters, syllables, and even whole words.
Semantic aphasia is characterized by the violation of understanding the meaning of phrases that are connected prepositions, conjunctions, and so on Patients well say, you know addressed to them it, but can't understand the difference in such phrases as "the brother of the father" and "the father of brother"; can show the pencil key, but don't understand the job to show the pencil key or key pencil. Semantic aphasia often combined with amnestic disorder of speech.
When amnestic of aphasia patients forget the names of items. Instead of calling the spoon, a pencil, they describe their quality and purpose: "this is what they eat," "that is what I am writing". But often it is enough to pronounce the first syllable, so that the patient remembered the word and she said it, but after a few minutes, he again it forgets.
In total aphasia patient does not speak or understand speech. Reading and writing impossible.
In all forms of aphasia is necessary to treat the underlying disease and hold long speech therapy. We must remember that aphasia is not a mental disorder, and these patients cannot be treated by psychiatrists.

Aphasia (from the Greek. aphasia is loss of speech) - speech-impaired due to changes within or actually the second signal system (I. P. Pavlov), performing the analysis and synthesis of words that represent the signals signals", or ratios of the second signal system with the first. Thus, out of aphasia are excluded dizartria (see) and the violations of speech, which depend on the deaf (deaf not to hear the speech, aphasia patient hears it but did not understand its meaning, does not accept the word as "alarm signal").
In the second signal system, as well as in the first, there are afferent and efferent part; the word is not pronounced only person to communicate with their own kind, but is perceived by them. Therefore, we can speak about expressive speech, which includes both oral and written speech (at the last written or printed word is the same "tone signals", but is a movement of a brush and is perceived by sight), and impressive speech - speech understanding in listening and reading. Voice single process, but it can be broken in its various parts, in accordance with what atasicice disorders are characterized by great diversity.
Disturbed may be particularly expressive (motor aphasia) or impressive speech (touch A.), speaking (actually A.) or written (Alexis - violation reading, ografia - violation of the letter).
The study atasicice violations. Oral speech. The study re-speech (letters, words, phrases), member of speech (the number series, enumeration, week days, months, and so on), the name of the displayed items, speaking (the answers), story. In the study it is necessary to pay attention to the desire or unwillingness to speak, poverty of speech, or mnogoluchevoi (logorea). When amnestic of aphasia fall specific designations, names of the objects. When motor A. suffers mostly grammatical structure speech (cases and declination) - the so-called agrammatism. The literal paraphasia characterized by swapping or replacing the letters of a word, verbal - replacement of the words in the sentence.
Written speech. The patient was given to write, write from dictation, write memorized earlier words, the title of the displayed items; to write the answers to the questions orally or in writing, questions, stories on the topic, the recitation of a literary work.
Understanding of oral speech. Understanding the meaning of words, phrases, showing called objects, understanding and implementation of simple and complex (multicomponent) instructions (you need to exclude apraxia), understanding the story with a simple content or complex in semantic terms. It is important to determine the diffusion of speech perception, which meant phrases and instructions with a ridiculous content, with the extra words, grammatical and syntactical errors, etc.
The reading. Separately investigate the reading and comprehension myself, as there may be occasions when these functions are violated more or less independently of each other. Explore the music of the speech as expressive and impressive (both visual and auditory). Violations of musical speech carry the name of amuse.
Symptoms of aphasia. In those cases, when the lesion is very large (stroke, trauma) and has initial stage lesions (dishes, irradiation braking), violation covers all aspects of the speech process and occurs total aphasia. Total A. sometimes remains in the future, but in many cases it some extent restored and identifies syndromes that detect dissociation speech functions that in the milder cases can be observed in the initial phase of the disease. The main forms of afasi characterized dislozierung speech, are motor, sensory, conductors, amnestic aphasia, Alexis.
Motor aphasia (aphasia B rock) is characterized mainly by the violation expressive oral and in most cases written speech. In severe cases it is not possible or is limited to "speech remnants" - interjections, stereotypical meaningless sound combinations, the usual oaths, etc., In less serious cases the usual symptoms are speech spontannosti agrammatizm, literal parafii. Repetition and ordinary speech are violated, but often less than speaking and story. Violations of the letter have the same character as that of violations of oral speech. Extremely rare is the so-called clean (subcortical, Wernicke) motor aphasia, which is broken only speaking and writing remains intact, thus showing that inner speech. There are cases (transcortical motor A.), when only violated free speech and writing, and repeat, ordinary speech and cheating are saved.


Sensory aphasia (aphasia Wernicke). The main symptom violation understanding of oral and written speech. In severe cases, the patient includes speech as any noise, no meaningful value. In less severe in the chaos of sounds he picks up individual words is the most common, especially his name. Expressive speech impaired, but in a different way than motor A. When the last patient says reluctantly and little, if sensory A. he was too voluble (logorea), said smoothly, without strain. However, this voluble products can be so rich verbal parapanema and perseverantiae that it is completely incomprehensible. The patient understands the reading and speaking, correctly picks up in the text, only the individual, the most familiar words. In more rare cases when "clean" (subcortical, Wernicke) touch A. oral and written language, and reading comprehension (internal speech) are saved, disturbed only understanding of oral speech. There are many cases of sensory A. (transcortical sensory A., Wernicke)when saved repetition of the violation comprehension.
Conduction aphasia is characterized by Wernicke, profesijai, violations of repetition, reading and writing while maintaining speech understanding and cheating.
When amnestic A. the patient forgets the names of items in a well-preserved structure of sentences and the absence of paraphase. The same "forgetting" signs characterized and written speech.
Alexis, as agraphia, observed in varying degrees in most cases, motor and sensory A., but it occurs sometimes in isolation, in the form of "pure spiritual blindness": the patient sees the written word, but does not understand its meaning.
Topologicheskie is atasicice syndromes. Nature atasicice syndromes is determined by the location of the injury, the nature of the pathological process, a common condition, especially the state of vascularization of the brain, the age of patients, their premorbid state, the type of higher nervous activity. When motor aphasia defeat always is localized in the zone of distribution of the front of the branches of the left (right-handed) middle cerebral artery, most often (though not always) with damage to the brains of Brock.
Sensory aphasia occurs with the defeat of the left (right-handed) temporal area. And in such cases it is impossible to speak about any localized within this zone, although the lesions are most often found in the rear Department of the superior temporal gyrus (rear Department of the field 22). Amnestic A. more likely to occur in cases when the source is located in the transition temporo-parietal-occipital sub-region (box 37), net Alexis - with the defeat of the angular gyrus (box 39).
The course and prognosis of aphasia depend largely on the nature of the underlying disease. As a temporary phenomenon A. occurs in rare cases during the migraine attack or in connection with an epileptic seizure. The forecast under other equal conditions more favorable for touch A., than when the engine, and much better at younger ages than in the old. Therapy should be directed to the treatment of the basic disease, are of great importance and special events systematic exercise in speech and writing.