50. Aphasia

Question 1

What is aphasia?

Answer 1

Acquired disorder, combination of a speech and language disorder. Usually focal brain lesion.

Question 2

Cause

Answer 2

Brain damage, secondary with neurodegeneration or mass lesions

Question 3

Diagnosis

Answer 3

Assessment of language function and evaluate neighborhood signs to find localization and cause

• difficulties w/vision, esp. hemianopia
• deficits of motor or sensory function
• neurobehavioral deficits such as alexia, agraphia, acalculia, or apraxia

Certain localized lesions of the brain can be distinguished by testing:

• Repetition
• Fluency
• Comprehension
• Naming
• Writing
• Reading

Question 4

Signs and symptoms

Answer 4

Problems with naming (anomia) or writing are common in most of types of aphasia

Question 5

Types

Answer 5

Broca: Broca’s area, right hemiparesis
Wernicke: Wernicke’s area, right upper visual field cut
Conduction: Arcuate fasciculus area
Transcortical motor: Near Broca’s area, right hemiparesis
Transcortical sensory: Near Wernicke’s area
Global: Large left hemisphere lesion, severe right hemiparesis
Subcortical: Left basal ganglia thalamus, hypophonia

Question 6

Wernicke’s aphasia

Answer 6

Sensory or receptive aphasia, language comprehension problem
Fluent speech, lack in key substantive words (nouns, verbs, adjectives), and may contain incorrect words or even nonsense words

Causes: Strokes inv. inferior division of MCA, emboli, lesions
- Lesions: May not accompanied by weakness or sensory loss, but contralateral homonymous superior quadrantanopia

Question 7

Broca’s aphasia

Answer 7

Problems with language production
Speech nonfluent, prob. prod. long string of words, hesitations and tip-of-the-tongue, telegraphic, paraphasias, overuse phrases
Subtle deficit of comprehension (e.g. complex grammatical constructions)

Causes: Large stroke of MCA, tumors, hemorrhages and other lesions
- Stroke: Typically ass. w/weakness of contralateral side