Types of aphasia

Aphaisa

- A disorder that results from damage to the parts of the brain that contain language. Aphasia can cause problems with any or all of the following: speaking, listening, reading, and writing. - Damage to the left side of the brain causes aphasia for most right-handers and about half of left-handers. Individuals who experience damage to the right side of the brain may have additional difficulties beyond speech and language.

Signs and Symptoms

- Aphasia can cause problems with spoken language (talking and understanding) and written language (reading and writing). Typically, reading and writing are more impaired than talking or understanding, but often mirror the expressive speech. - Aphasia can be mild or severe depending on the amount and the location of the damage to the brain.

Conduction aphasia

- Damage in the Arcuate Fasciculus - Speech output is fluent but there are a lot of phonemic paraphrasias which are recognized and results to unmelodic speech. - Poor repetition Good auditory comprehension - Good silent reading poor aural reading (like verbal output) - Naming is usually impaired

Expressive aphasia

- Difficulty using words and sentences - Short or incomplete sentences (omits smaller words) - Use words that don't make sense (jargon) - May have difficulty finding words - May put words in the wrong order - May switch sounds

Nonfluent aphasia

- Global Aphasia - Isolation Aphasia - Broca's Aphasia - Transcortical Motor Aphasia

Isolation aphasia

- Lesion high in the frontal lobe - Some verbal output- minimal, single words - Improvement is sudden - Can repeat - Naming is ok - Usually occurs in the acute stage

Broca's aphasia

- Lesion in 3rd frontal convolution (brocas area) aka inferior frontal gyrus. - Relatively good auditory comprehension - Non-fluent, agrammatic speech= poor expression - Impaired repetition - Writing is like speech, mirrors speech - Frontal alexia (may have)- reading comp usually parallels aud. comprehension. - Awareness of errors and difficulty - Apraxia of speech - Poor naming

Wernike's aphasia

- Lesion in Heschyle's gyrus in posterior temporal lobe - Speech is fluent or hyperfluent - Paraphasias (replacing words or sounds with others) and neologisms (making up new words) - No self-awareness or awareness of others logorrhea (faster than press) - Auditory comprehension is impaired - Repetition is poor - Naming is poor - Reading and writing is impaired and mirrors speech

Global aphasia

- Lesion in the left perisylvian Fissure or a deep subcortical area - No communication modality preserved - May have only steroptypical utterances - Usually in acute stage, evolves to brocas aphasia as it improves.

Transcortical sensory aphasia

- Lesion in the posterior temporal lobe extending to the visual and auditory cortex. - Good repetition - Poor auditory comprehension (varies) - Fluent output with some paraphasias anomia (word finding difficulties) - Incoherent expression with circumlocutions and perseverations - Reading and writing impaired.

Receptive aphasia

- May struggle with both using words and understanding. - Difficulty comprehending others.

Transcortical Motor aphasia

- Mildly impaired comprehension - Production like brocas - Poor reading comprehension - Poor naming - Good repetition - Lesion in motor cortex

Fluent aphasia

- Wernicke's Aphasia - Transcortical Sensory Aphasia - Conduction Aphasia - Anomia

Anomic aphasia

- Word finding difficulties - Lesion in the temporal parietal area - Grammar is unaffected - Paraphasias are rare - Repetitions are good - Auditory comprehension is relatively intact

Paraphasias

A paraphasia is a symptom of commission in that it is an incorrect word substituted for an intended or target word. It is the product of a breakdown at a stage of word-retrieval process and is a dominant symptoms within the more general category of anomia.

Verbal stereotype

A verbal stereotype is a very restricted form of expression as it is used repeatedly by a patient, as if it were the only language form available.

Written language

Aphasic writing usually exhibits patterns which are similar to the speaking impairment. The writing component of aphasia is called agraphia. Linguistic symptoms can be masked by right-handed muscle weakness and by left-handed awkwardness.

Auditory comprehension

Aphasics with disturbances in the comprehension of spoken language hear the speaker but have difficulty understanding what is being said. The problem tends to become worse as utterance length or complexity is increased. Patients have difficulty when they are competing signals or when there is a rapid change in the nature of content of the message Patient's ability to comprehend may depend upon the general familiarity of the words used, the length, and informational content of the message, grammatical complexity, and intellectual demands. These deficits include failure to follow an instruction correctly, or irrelevant responses to questions.

Jargon

Category of symptoms which include inadequate sentence productions. Agrammatism refers to attempts at sentence formulation in which the muscle is present but the skeleton is missing. Content words, such as nouns and verbs, are produced; but function words such as articles, verb auxiliaries, and prepositions, are omitted. Utterances sound like a telegram (telegraphic speech). Example: (1) Uh, boy...and, uh, girl; (2) Mother, father...making dogs,...hot dogs; a boy, no two boys...and baseball; (3) Its a mother and a father fixing hot dogs..a picnic; I have two sons like this...boys playing baseball.-

Nonfluent aphasia

Damage to the language network near the left frontal area of the brain usually results in Broca aphasia, which is also called nonfluent aphasia. Often Brocas Aphasia is accompanied by Apraxia of Speech due to the closeness in proximity in the brain. - Slow labored speech - Struggle to retrieve words and/or formulate sentences - May have slow rate, reduced intonation, inappropriately placed, long pauses, apraxia, less varied stress patterns than typical speakers

Circumlocutions

Some patients, unable to evoke an elusive word, substitute another word, phrase, gesture or use circumlocutions (i.e., they talk around or about the specific word. The circumlocuting patient might say, "I wear it right her (pointing to his wrist) " and I tell time with it."

Reading

The reading deficit in aphasia has been called alexia, dyslexia. The dyslexias are observed in two ways, either during silent reading for comprehension or during reading aloud.

Fluent aphasia

Wernicke aphasia is the result of damage to the language network in the middle left side of the brain. - Word substitutions, neologisms, verbose verbal output. - Lesion in posterior portions of the left hemisphere. - Typical rate, intonation, pauses, and stress patterns.

Phonemic paraphasia

also called literal paraphasias, involve the substitution, addition, or rearrangement of speech sounds so that the error can be identified as sounding like the target. Goodglass and Kaplan (1972) used the criterion that more than half of the intended word is preserved. Examples: pike/pipe, kipe/pipe

Agrammatism

category of symptoms which include inadequate sentence productions. Agrammatism refers to attempts at sentence formulation in which the muscle is present but the skeleton is missing. Content words, such as nouns and verbs, are produced; but function words such as articles, verb auxiliaries, and prepositions, are omitted. Utterances sound like a telegram (telegraphic speech). Example: (1) Uh, boy...and, uh, girl; (2) Mother, father...making dogs,...hot dogs; a boy, no two boys...and baseball; (3) Its a mother and a father fixing hot dogs..a picnic; I have two sons like this...boys playing baseball.

Verbal paraphasia

identified based on whether there is a semantic relationship between the error and the intended word. Examples: wife/husband; talking/hearing

Anomia

refers to word finding difficulty. Patient is unable to evoke, retrieve, or recall a particular word. The problem is most evident in the case of nouns, but this may be because nouns constitute a large proportion of a speaker's word use. Some patients, unable to evoke an elusive word, substitute another word, phrase, gesture or use circumlocutions (i.e., they talk around or about the specific word. Verbal paraphasia and circumlocutions may be examples of a more generalized category of symptoms called anomia.

Neologistic Paraphasia

spoken words which cannot be identified as having come from the patient's language. Example: planker/comb; pinwad/light