Aphasias Flashcards
Broca’s
nonfluent, intact comprehension, impaired repetition, limited naming, limited reading, impaired writing like speech
impaired speech planning and production
posterior aspect of third frontal convolution (damage adjacent motor fibers may produce right hemiparesis - mostly arm more than leg, with right facial droop)
wernicke’s
fluent, impaired comprehension, impaired repetition, impaired naming, impaired reading, impaired writing
impaired representation of sound structure of words
posterior half of superior temporal gyrus (genivulostriate white matter can produce right homonymous hemianopia); can include superior quadrantopsia
anomic
fluent but empty, intact comprehension and repetition, impaired naming, intact reading, impoverished content in writing
primary issue is with word finding, causing long pauses, frequent circumlocution, stumbling verbal output
often residual disorder following other aphasias
impaired storage or access to lexicon
inferior parietal lobe or connections within perisylvian language areas; other aphasias often turn to anomia in recovery
transcortical motor
nonfluent, intact comprehension and repetition, limited naming, intact reading, impaired writing
anterior borderzone, resembles broca’s except for intact repetition
disconnection between conceptual word/senetnce representations in perisylvian region and motor speech areas
deep white matter tracts connecting BA to parietal lobe; usually cause by anterior watershed infarcts; occasional right hemiparesis
transcortical sensory
disturbed activation of word meanings despite normal recognition of auditory presented words
white matter tracts connecting parietal and temporal lobes; usually cause by posterior watershed infarcts; common hemisensory defect and uncommon right hemiparesis
conduction
fluent, intact comprehension, impaired repetition, impaired naming, intact reading, impaired writing
impaired repetition in the context of relatively fluent speech and well-preserved auditory comprehension
literal paraphasias, word finding issues, severely impaired writing is common; naming can be limited by paraphasia, reading aloud disturbed but comprehension may be good
damage to arcuate fasciculus (which connects broca’s and wernicke’s); can include hemisensory defect and cortical sensory loss
global
nonfluent with impaired comprehension, repetition, naming, reading, writing
usually due to occlusion early in the MCA vascular tree; common right hemiplegia and right hemisensory neglect
subcortical
can fluent or nonfluent, intact comprehension and repetition, impaired naming, intact or impaired reading and writing
language disorders that can come from damage to striatum, internal capsule, thalamus. when lesion is subcortical, prognosis for recovery is very good with maybe some residual impairment; but if cortical, aphasia may persist
transcortical mixed
nonfluent but echolalia, impaired comprehension, intact repetition, with impaired naming, reading, and writing
combines motor and sensory and resembles global, except with ability to repeat
extensive borderzone damage - common causes are hypoxic brain injury due to decreased cerebral circulation such as cardiac arrest, carbon monoxide poison, temporary occlusion/stenosis of carotid artery; common. right hemiparesis and hemisensory defect
6 areas to test for aphasia
spontaneous speech, comprehension, repetition, naming, reading, writing
general aphasia info
acquired loss or impairment of language following brain damage or disease - does not include developmental disorders
primary etiology is stroke, but can also be due to neoplasm, intracranial tumor and infection, TBI, brain diseases affecting language ares such as FTD
nonfluent aphasias associated with dysfunction in anterior language centers
fluent aphasias in the posterior language areas
aphasic disorders without repetition issues are in borderzone language areas; with repetition issues are in perisylvian areas
most improvements will happen first few months after injury and extent/persistence of deficits will be related to size and location of lesion
strokes in the cortex only tend to have better outcomes than those in deeper structures ad white matter pathways that connect them bc cortex strokes are less disruptive of multiple systems needed for language. strokes that affect both have worst outcomes
perisylvian aphasia syndromes
structures around the Sylvia fissure; hallmark is impaired repetition
nonfluent syndromes: broca’s
fluent syndromes: wernicke’s, conduction
extrasylvian aphasia syndromes
borderzone region are known as transcortical aphasia syndromes
ability to repeat but with distinct language impairment
nonfluent: transcortical motor, mixed transcortical
fluent: transcortical sensory
nonlocalizing aphasia syndromes
anomic and global
Alexia
inability to read unrelated to simple sensory or motor issues
without agraphia: pure word blindness; rare and involves selective loss of ability to read configurations of letters without disturbance in writing ability without other language disturbance. pt can write, but cannot read own writing; can have color anomia, trouble spelling and comprehending spelling, bilateral visual field hemianopsia
with agraphia: specific loss of ability to read with specific loss of writing ability in spite of intact manual motor abilities. speech and comprehension may be intact, but may have anomia; common right hemiparesis and hemisensory neglect
