Pathological reactions occurring in the cerebral cortex are accompanied by disorders and disruptions of the body’s usual functions. Damage to the parietal, frontal or temporal regions threatens with aphasia - problems with formed speech. Depending on the location of the process, the disease can take different forms. Sensory aphasia develops against the background of damage to the area of the superior temporal gyrus, and specifically, the primary auditory field. The condition is characterized by a clear clinical picture and requires an integrated approach to treatment.
Motor cortical aphasia (Broca), verbal, expressive aphasia
Motor cortical aphasia is characterized by impairment of oral speech, writing, and reading. Motor cortical aphasia occurs when the posterior parts of the inferior frontal gyrus of the dominant hemisphere are damaged. In mild forms, speech is slow, ungrammatical, the construction of phrases is impaired, and the set of words is reduced. Synonyms for motor cortical aphasia are Broca's aphasia, verbal aphasia, and expressive aphasia. With severe disorders, patients use only a few words or syllables (speech embolus) to express various shades of their emotions.
Treatment
Therapy is also carried out in a hospital. In the early stages, treatment includes several stages: primary care immediately after admission to the hospital (especially if the patient is in serious condition), early measures aimed at relieving symptoms and combating the root cause, late stage and, finally, rehabilitation.
Nootropic drugs (Glycine, others), as well as cerebrovascular, antihypoxic medications (Piracetam, Actovegin and their analogues) are used. Often this is enough if the case is not advanced. Long-term use of medications is possible. For malformations, aneurysms, and tumors, surgical treatment cannot be avoided. It is necessary to remove them and restore normal tissue trophism, eliminating compression (squeezing).
Injuries with the formation of hematomas require drainage, that is, removal of the blood clot itself.
Epilepsy is a separate problem. The only way to correct the disorder is to systematically use antiepileptic medications as prescribed by a doctor.
Even after quality treatment in severe cases, usually post-stroke, neurological deficits remain. The patient still speaks poorly and does not perceive speech well. The issue is being resolved as part of rehabilitation. It takes from 6 to 12 months, rarely a little more. The time it takes to achieve results is 2 years. This is just a period of adaptation, restructuring the brain in a new way. Then achieving any effect is difficult or even impossible.
Exercises for semantic aphasia (sensory) are quite simple:
- reading and pronouncing simple words;
- delimitation of similar-sounding terms;
- the relationship between the image and the name of the depicted object;
- dialogues, at first simple, then increasingly complex.
Recovery is a routine and unpleasant task for the patient. But necessary. Depending on the quality of assistance, we can talk about one or another intensity of recovery.
Correction of deviations in Wernicke's aphasia is carried out according to indications. Usually everything is limited to the systematic use of cerebrovascular drugs, nootropics, and angioprotectors.
Sensory cortical aphasia, Wernicke's aphasia, word deafness
Sensory cortical aphasia has several synonyms - Wernicke's aphasia , word deafness . Sensory cortical aphasia is characterized by a lack of understanding of the normal correct speech of others with preserved hearing. Patients with sensory cortical aphasia speak a lot, but their speech consists of a random collection of words and sounds. Sensory cortical aphasia is observed with damage to the posterior parts of the superior temporal gyrus of the dominant hemisphere. Sensory cortical aphasia is often combined with acalculia.
Symptoms
The clinical picture of speech disorder consists of separate groups of speech pathologies. Signs of sensory aphasia:
- Impaired speech understanding. It is characterized by a loss of word recognition skills, namely: phonological and semantic structures. Patients distinguish individual sounds well and understand their structure; the problem arises at the level of combining sounds into a word.
- Impaired understanding of spoken language. The degree of speech understanding in sensory aphasia is reduced to a minimum. The problem arises at the level of phonemic, syntactic and semantic structures. Even contact with a doctor is often difficult. Patients carry out commands and requests during diagnosis only after the doctor touches them. Complicates contact and impaired understanding of the meaning of elementary gestures.
- The phenomenon of alienation of the meaning of a word. The violation is observed at the semantic level. The term was introduced by A. Luria. The point is that the patient pronounces the word correctly, repeats after the researcher, but has no subject correlation. This means that, repeating the word “table” or “chair” several times, the patient cannot point his finger at the table and chair, since he does not understand what these terms mean.
- Pathology of the phonological level. Usually observed in patients with moderate severity of dysphasia. The syndrome can be easily understood by considering the following clinical example. The doctor tells the patient: when I say “A”, you raise your hand, when I say “O” you do not raise your hand. After voicing the letters, the patient correctly follows the commands. However, difficulties arise when several vowels are combined, for example, if you attach the command “raise your hand” to the combination “A O U”, the patient will not carry it out. Impaired comprehension at the phonological level is demonstrated when attempting to rewrite a word. Thus, the patient only copies the letters, without relating them together and without understanding the meaning of what is written.
- Pathology of word perception at the auditory level. Verbal deafness is expressed in a lack of understanding of the spoken phrase.
See also: How to treat Aphasia?
- Auditory agnosia. This is expressed in the fact that the patient correctly and adequately perceives non-verbal sounds. The patient recognizes the noise of the wind, the hum of engines, piano notes and birdsong and can correctly identify the sound and the source.
- Expressive speech impairment. It is most clearly expressed in the first week after a stroke. Characterized by a continuous stream of barely intelligible sounds and phrases. Short syllables predominate. Sentences and phrases are mostly fluid. This is the main difference from Broca's dysphasia, in which speech is abrupt and with long pauses.
- Pathology of dialogue. Patients have difficulty finding the right words in conversation. Speech production increases, that is, patients speak a lot, but not clearly. In severe dysphasia, speech is completely unclear to others, as it represents a stream of different sounds that do not form words or phrases.
- Violation of the nominative function. This is expressed in the fact that the patient cannot name the name of an object, phenomenon or action.
- Pathology of articulation, facial expressions and gestures. Symptoms of the disorder are rare. Usually they are expressed in a violation of the selection of intonation and incorrect vowel duration.
- Agraphia and alexia. Reading and writing from dictation are partially impaired.
Sensory dysphasia is often accompanied by other neurological disorders, especially after stroke. Dysphasia is combined with a right-sided decrease in muscle strength (hemiparesis), with weakness in the right hand, right-sided visual impairment, or with a decrease in sensitivity according to the hemitype.
How to treat aphasia, get rid of aphasia?
Sarklinik knows how to treat aphasia , speech disorders characterized by partial or complete loss of the ability to use words and phrases, how to get rid of aphasia in Saratov. A variety of reflexology treatment methods have helped many of our patients get rid of aphasia in right-handed and left-handed people. Effective treatment of aphasia gives excellent results; patients (children and adults) restore lost speech abilities and begin to understand their thoughts and the speech of others. On our website sarclinic.ru you can see a doctor for free and get a short answer on the treatment of aphasia.
Aphasia after stroke
Among the complications of acute cerebrovascular accident, speech disorders occupy one of the leading places. To combat acoustic
Gnostic aphasia against the background of a cerebral catastrophe, it is recommended to begin rehabilitation measures as early as possible. After stabilizing the patient, procedures selected by the speech therapist on an individual basis can be introduced into his regimen. At the initial stage, singing songs, reading poetry, counting, and listing the days of the week and months gives a good effect. Work continued after discharge from the hospital can restore functions lost due to extensive brain damage.
Treatment of aphasia in Saratov, Russia
At your first consultation you will receive information about the treatment of aphasia and the following questions. Semantic and traumatic aphasia. How does speech restoration occur in aphasia? How does speech sound in patients with aphasia? What is optic-mnestic aphasia, afferent and efferent aphasia, dynamic acoustic-gnostic and acoustic-mnestic kinesthetic aphasia? How are stroke (a condition after a stroke), alalia, agnosia, apraxia and aphasia disease related and how do they differ? How are patients examined and speech therapy work done for aphasia? Why do you need an aphasia speech map? What exercises should you do for aphasia?
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Photo: Santos06 | Dreamstime.com\Dreamstock.ru. The people depicted in the photo are models, do not suffer from the diseases described and/or all similarities are excluded.
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Causes of pathology
The risk group for sensory aphasia includes older people and people with heart and vascular diseases.
In children, pathology is recorded much less frequently than in adults. In some cases, the damaging effect on the central nervous system manifests itself immediately, in others, up to several years may pass from the moment the problem appears.
Wernicke's aphasia in an adult can result from the following factors:
- acute cerebrovascular accident. Ischemic and hemorrhagic strokes are considered the most common triggers of the disorder;
- decreased functionality of cerebral vessels. Emboli, tissue hypoxia as a result of narrowing of the lumen of blood channels, instability of blood flow pose a serious danger to the speech functions of the brain;
- traumatic brain injuries. Capable of causing immediate or delayed damage to the tissue structure in the skull;
- benign and malignant formations in the brain;
- aneurysms of cerebral vessels. Acoustic-gnostic aphasia can occur as a result of rupture of the protrusion of the canal wall or its pressure on the cerebral cortex in the temporal region;
- inflammatory lesions of the central nervous system;
- abscesses that can form in the temporal region after a complicated course of otitis media;
- diseases leading to degeneration and demyelination of brain tissue and its membranes.
In childhood, acoustic-gnostic disorder most often results from head trauma. Particularly dangerous are complicated childbirths, the consequences of which may appear several years later. Congenital vascular pathologies, tumors, infections and inflammatory processes also act as increased risk factors.
Diagnostics
Diagnosis of aphasia lies in the competence of speech therapists, neuropsychologists and neurologists. The following studies may be prescribed:
- computed tomography of the brain
- magnetic resonance imaging of the brain
- lumbar puncture
- duplex scanning of cerebral vessels
- Doppler ultrasound of head and neck vessels
- magnetic resonance angiography
The following examinations should be carried out if aphasia is suspected:
- letter diagnostics
- diagnostics of oral speech (impressive and expressive)
- auditory-verbal memory test
- motor memory test
- diagnostics of the state of visual memory
They also carry out diagnostics:
- intelligence
- constructive-spatial activities
- visual gnosis
- praxis (dynamic, somato-spatial, finger, hand, facial, oral)
Differential diagnosis of aphasia with the following diseases is required
- mental retardation
- hearing loss
- dysarthria
- children's alalia
Manifestations of the disease
The group of symptoms that manifests itself to a greater extent depends on which area of the brain is affected when sensory aphasia occurs. In any case, this is Wernicke’s area, where the speech analyzer is located, but the specific characteristics of sensory aphasia depend on whether the left or right hemisphere is affected: the perception or reproduction of speech is more impaired.
For a patient with sensory aphasia, words are just a collection of sounds. In some cases, recognition is partially preserved: the patient can identify the object shown to him as living or non-living, large or small. But he is unable to name the object itself. At the same time, the patient, as a rule, can perform simple actions on command - stand up, raise his hand, turn around. Without treatment, the disease progresses and leads to a complete misunderstanding of what is being said. Your own words are also not perceived as speech. Due to the lack of control by hearing, words become incoherent and are pronounced incorrectly and sometimes unrecognizable. Intonation also suffers. Pronunciation may be restored, but the construction of phrases will not appear on its own. Patients try to talk, and get angry when those around them do not understand them: a patient with sensory aphasia is sure that he speaks clearly.
Writing is also impaired to the same extent as speech. But the ability to read is lost only slightly - mainly due to confused stresses that distort the meaning of words.
