Sudden speech disorder or aphasia

Sensory aphasia is manifested by problems in speech activity that arise when the centers of the cerebral cortex and their pathways responsible for speech are damaged. Patients confuse sounds and are unable to name objects. These disorders are designated by the term “aphasia.”

The site provides reference information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious doctor. Any medications have contraindications. Consultation with a specialist is required, as well as detailed study of the instructions! Here you can make an appointment with a doctor.

Symptoms

Doctors distinguish the main types of the disease depending on the location of the pathology and specific manifestations of speech dysfunction:

1. People suffering from motor aphasia understand words addressed to them, but find it difficult or unable to pronounce a phrase or a single word. In severe cases, the ability to speak is completely lost or reduced to the reproduction of short fragments of the same type.
2. In the sensory form of aphasia, or Wernicke's aphasia, the patient can speak, but does not understand his native speech.

With the sensory form of aphasia, patients experience the following symptoms:

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• The sufferer hears well everything that is said, but cannot interpret the sounds of the speech stream. Words spoken in his native language seem to him to be complete nonsense, like foreign speech, like noise devoid of informational meaning.
• Patients do not experience difficulties in pronouncing phrases, they are often verbose, but their speech is uncontrolled, fragmentary, incoherent, and devoid of meaning. It is full of service words and its own neologisms to the detriment of verbs and nouns.
• The patient's behavior is often agitated, he is emotional, and moves a lot. He is very annoyed because he is not understood, but he himself is not able to appreciate the lack of information in his speech flow.
• In mild forms of the pathology, the patient understands and carries out certain simple commands. This feature allows doctors to differentiate sensory aphasia from diseases that are associated with hearing or mental impairment. The sufferer catches individual words in the speech stream, can accurately repeat phrases, but the general content of the speech remains incomprehensible to him.
• Pathologies are often accompanied by visual impairment - hemianopsia, when the right half or upper quarter of the visual field of both eyes falls out. The mobility of the facial muscles on the right is limited.

As the disease progresses, new lesions may appear, causing additional speech disorders.

Kinds

Neuropsychological classification

In Russia and the post-Soviet space, the classification of aphasia by A.R. Luria , Russian neuropsychologist.

Luria identifies the following types:

1. Acoustic-mnestic;
2. Acoustic-gnostic, or sensory aphasia;
3. Semantic aphasia;
4. Motor: Afferent motor aphasia Efferent motor aphasia Dynamic aphasia

The acoustic-mnestic variety occurs when the temporal region of the head is affected. Characteristic symptoms:

It is difficult to comprehend fast, multi-threaded speech (in a large group of people, noisy environment), speech containing long sentences, atypical phrases.

Ability Retained:

• To reading, with a slight decrease in speed and quality.
• Independent expression of thoughts, including in writing.

acoustic-gnostic aphasia are damage to the sensory speech area.

The etiology of acoustic-gnostic aphasia leads to incorrect phonemic analysis and synthesis, which leads to the following consequences:

• Manifestations of agraphia and alexia
• Speaking is confused, parts of phonemes are in the wrong order
• Auditory perception is limited or absent.
• The remaining consequences are similar to those given above for the acoustic-mnestic variety.

semantic aphasia manifests itself . The main symptom for the diagnosis of “semantic aphasia” is a lack of understanding of grammar, in particular:

• Passive voice (the distinction between “the author sculpts a sculpture” and “the author sculpts a sculpture” is erased)
• Locations expressed by prepositions (“on the table” and “under the table” can become synonymous concepts).

Semantic aphasia, like others, from the outside looks like communication with a person from a foreign language environment.

Efferent motor aphasia is characterized by the phrase “I understand everything, but I can’t say anything”:

• What is said is abrupt and inconsistent in declensions and cases
• Duplicating individual pieces, replacing them in places
• Reading or writing anything is extremely problematic.

It is diagnosed in the lower frontal lobes.

If motor aphasia is afferent, then we are talking about problems of the lower parietal region. It follows from here:

• Difficulty moving the muscles of the face, tongue, jaw
• Articulation disorders
• Diction is unclear, blurry
• The simplest manipulations of the lips are impossible (pout, stretch into a wide smile, roll into a tube).

Dynamic aphasia is associated with incorrect functioning of the frontal lobe on the left side. Even the slightest injury due to TBI can be to blame.

The disease reveals itself as problems:

• With retelling
• With phrase construction
• Poor vocabulary
• With long monologues

Neurological classification of Wernicke-Lichtheim

Three subgroups include the Lichtheim-Wernicke classification of , used abroad:

1. Sensory, or Wernicke's aphasia (resembles acoustic-gnostic).
2. Motor, or Broca's aphasia (develops when Broca's center is damaged and has the same clinical manifestations as efferent motor aphasia).
3. Transcortical (motor and sensory aphasia, the same as dynamic aphasia. A patient with sensory aphasia differs from a person with damaged Wernicke’s area only in the ability to repeat phrases after others).
4. Conduction aphasia (characterized by the complete absence of this skill).
5. Amnestic (observed when the temporo-parietal part of the head is affected).

• Amnestic-semantic (prevents memorizing what is heard).
• Optical-mnestic (recognition of things suffers - if a person is shown a card with an object, he will not remember the name).
• Acoustic-mnestic (expressed in the difficulty of choosing words and giving definitions).

1. Sensorimotor aphasia (in the worst case, it becomes synonymous with the diagnosis “total aphasia” - complete loss of communicative abilities).

Forms

In practice, mixed forms are more common than sensory or motor aphasia in its “pure” form. Additionally:

• Transcortical sensory, or semantic, aphasia. Difficulties and errors arise when perceiving complex lexical and grammatical structures, especially those reflecting spatial relationships;
• Conductor. Problems arise when trying to repeat sentences after the doctor, when reading aloud;
• Amnestic, which occurs during the progression of Alzheimer's disease.
• With the acoustic-mnestic variant, the patient distinguishes phonemes, but cannot form words from them, especially nouns. The speech is poor, there are many pronouns. It is somewhat difficult to understand what is heard and read.
• Patients with the optical-mnestic subtype successfully recognize objects, but cannot remember their names without additional prompting.
• The most severe sensory-motor variant of aphasia occurs after strokes, when there is a large lesion. The patient is unable to understand speech and finds it difficult to say anything. Sensory-motor aphasia is often total due to the complete loss of speech function.

Sensory aphasia

Articulation

Oral and articulatory praxis without impairment.

Spontaneous speech

Spontaneous (oral) speech is also characterized by the presence of lateral and verbal paraphasias and elements of logorrhea. There are agrammatisms of agreement. The pace of speech is somewhat accelerated, but there are pauses within words and between words, due to attempts at self-control and self-correction. The lexical composition of a statement is represented by various parts of speech, among which verbs, interjections, pronouns, and various modal-evaluative words nevertheless predominate. There are words with concrete and abstract meanings. There are speech cliches in which their own paraphasias are woven, built on individually strengthened speech cliches. As a result of the inability to change the utterance in accordance with the situation of verbal communication, its individual fragments acquire an elaborate, bizarre, ornate sound. Despite the limited number of highly informative words, the general meaning of the statement remains intact. The intonation is bright. Facial expressions and gestures are emphasized. There are no pronunciation difficulties identified.

Speech automatisms

There are difficulties in all types of direct automated speech.

Repeated speech

When sounds are repeated, substitutions are noted based on their acoustic proximity; when repeating syllables, a tendency is revealed for their transformation in the comprehension of the word. When repeating phrases, it is typical to preserve the length of the sentence, its syntactic and prosodic pattern, with gross distortions of the lexical composition.

Dialogue speech

Dialogical speech is possible, but the answers are not always sufficiently informative. Often there is a lack of understanding of questions that are laconic in form, and therefore it is necessary to introduce additional words to explain them.

Naming

Pictures cope with the verbal presentation of the plot, but most often they consist of only a few fragmentarily constructed phrases, which often convey information that is not directly related to the plot. The task of speaking concisely (two or three words) is practically impossible.

Phrase based on the plot picture

The possibilities of constructing a phrase based on a plot picture correspond to the possibilities of oral speech.

Retelling texts

They retell the text, but often allow distortions that are characteristic of expressive speech in general. The general semantic orientation of the plot is conveyed. Elements of logorrhea (abundance of speech production) and some pretentiousness of presentation style are often noted.

Speech understanding

Understanding situational speech and understanding more complex non-situational types of speech are difficult. There are paragnoses (errors in comprehension), alienation of the meaning of a word into the names of individual objects and parts of the body. Verbal instructions are followed with frequent errors.

Volume of auditory-speech memory

The volume of auditory-speech memory is limited.

Read function status

Reading aloud is possible, but is accompanied by the same distortions as with other types of expressive speech. The patient recognizes individual letters and reads them aloud.

Writing function status

Severe violations of written speech are noted. It is possible to copy words and even simple phrases, but writing from dictation is replete with numerous lateral and verbal distortions of a non-standard type. There is a tendency to “attach” a sound to a word and thus facilitate the correlation of its acoustic and graphic image. When attempting to analyze the sound-letter composition of a word, gross errors are made in determining the quantity and quality of sounds.

Causes

Personal experience of perceiving the speech stream is lost due to disturbances in the normal functioning of the cortical part of the auditory analyzer, which is located in the temporal lobe of the cerebral cortex.
The auditory analyzer is responsible for processing and analyzing signals coming from the outside world. Malfunctions in its functioning are caused by:

1. Various types of strokes.
2. Traumatic brain injuries.
3. Neoplasms.
4. Aneurysms of cerebral vessels.
5. Consequences of encephalitis and other infections.
6. Some mental disorders.

Provoking factors include old age, heredity, hypertension, and heart defects.

Diagnostics

A neurologist diagnoses and treats aphasia.

• Initially, complaints and medical history are collected
• This is followed by a general neurological examination for the presence of external neurological abnormalities (drooping of the corner of the lips, deviation of the tongue when protruding, decreased tone of the limbs, etc.).

Additional diagnostic methods are prescribed:

• Computed tomography and magnetic resonance imaging - help to establish the cause of the disorder through layer-by-layer examination of brain tissue;
• Electroencephalography – determines electrical activity in various parts of the brain;
• Magnetic resonance angiography is performed if there is a suspicion of vascular obstruction.

Treatment

The rather long and labor-intensive treatment of sensory aphasia includes sessions with a speech therapist who has undergone special training.
Corrective work is aimed at restoring auditory perception, understanding of speech, reading, and writing.

Doctor-patient interactions are complicated by the difficulty of communicating with a person who does not integrate meaning from the sounds of their native language.

Therapy for this pathological condition includes:

• Medications: nootropic and neurotrophic drugs, vitamin therapy.
• Additional medications are prescribed depending on the causes of the pathology.
• Physical therapy classes, massage, and physiotherapeutic procedures are shown.
• In rehabilitation therapy, specialized computer programs are used to help improve speech abilities.
• At home, the patient needs a friendly, comfortable atmosphere and the patience of loved ones. Relatives will help speech rehabilitation if they talk with the patient more often, pronouncing simple phrases in a measured manner, involving him in a general conversation, listening to his opinion.

Participation in household chores as much as possible has a positive effect.

Exercises

The following exercises are recommended for therapeutic purposes:

• Working with subject pictures: classification of images by their names, characteristics, general categories.
• Selecting the correct name from several suggested ones.
• Differentiation of words that sound similar.
• Correlating images and text: writing stories based on pictures.
• Answers to questions: first they receive monosyllabic answers, then they practice dialogues from simple to more detailed ones.
• Reading and Writing: Start with individual letters and syllables, which are then put into words. Then they write simple dictations. Reading aloud begins with small texts, gradually moving to more extensive works. They master retelling and answer questions about the content of the text.

Aphasia after stroke

If the pathology has developed as a result of a stroke, corrective speech therapy classes begin in the first weeks, as soon as the attending physician allows.
At the beginning of rehabilitation, you need to rely on speech stereotypes: ordinal counting to 10, singing famous songs, recalling famous lines of poetry.

For such patients, the support of relatives is important. Here it is necessary to realize that a quick recovery should not be expected.

Try to focus on your achievements, even the smallest ones.

A positive environment can shorten the recovery period.

The earlier treatment and correctional measures were started, the more coordinated the joint work of the doctor, the patient and his family, the more favorable the prognosis.

In medical practice, there are examples of significant improvements in speech ability, even if aphasia occurs when a large volume of the brain is damaged (after injuries and cerebral hemorrhages).

Nutritional Features

The course of treatment for aphasia is long and difficult, therefore, when starting treatment, the patient and his entire family must be well prepared for a difficult battle for health. To achieve a 100% result from treatment, you need constant sessions with a speech therapist, psychologist, neurologist, and a wholesome, healthy diet. During treatment, the patient's brain is constantly working.

The patient may often sit in one position studying letters or reading a book. The diet of a patient with aphasia must be special. A person with this disease should have five meals a day, that is, he should eat food in small quantities and often.

You need to include in your diet something that helps your brain work well:

• Shrimp, lean fish; all seafood saturates the body with fatty acids, which help good attention and memory;
• Onions - it overcomes fatigue and nervous tension well, thins the blood, which further supplies the brain with oxygen;
• Nuts perfectly calm the nervous system due to their high content of vitamin B; fresh fruits, berries, especially avocados, bananas, blueberries, cranberries, strawberries, cabbage, beets, spinach, lemon, pineapple and others;
• Lean meat (beef, chicken);
• Dairy products (cottage cheese, yogurt, kefir);
• Legumes, cereals and pasta.

The breakfast of a patient with this disease should consist of 20% of the daily diet, for example, muesli with yogurt, porridge, boiled egg, second-grade bread, fruit. For an afternoon snack, you can have a small snack of some fruit or eat 100 - 200 grams of any nuts and drink drinking yogurt, kefir, tea with lemon. Lunch should consist of 40% of the daily diet, for example, a fresh vegetable salad, a piece of lean meat with potatoes, porridge, fresh berry compote or juice. For dinner, a piece of lean meat or fish, a vegetable salad, some fruit, or kefir is suitable.

The diet helps the brain function well, which helps quick reactions, thinking, and therefore a speedy recovery from such an unpleasant disease and the acquisition of full speech.

Treatment with folk remedies

There are no folk remedies against this disease. The disease can only be cured by daily sessions with a speech therapist. The most effective treatment methods are dolphin therapy, hippotherapy (treatment with horses) and feline therapy (treatment with cats).

Let's talk in more detail about these methods:

1. Hippotherapy (treatment with horses). During the presence of the patient next to the horse, his nervous system begins to calm down, which is considered the only advantage of classes with a speech therapist, which sometimes contributes to the person’s anxiety and inhibition of treatment. Communication with horses causes a lot of joyful emotions in a patient, helping to normalize brain function, which restores the immune system. When a patient comes to such classes, all problems leave him, he begins to speak well and understand the speech of others. And later he begins to understand everything and speak, even in another area. In addition to emotional communication, horseback riding develops motor skills in the patient, which restores brain cells. If you combine all this, then after several such sessions you can achieve excellent results, and a person will be able to return to their normal life.
2. Dolphin therapy. Dolphins are used in medicine and psychotherapy. During communication with dolphins, a person’s psycho-emotional state stabilizes and psychological stress is relieved. Dolphin therapy is a great way to get rid of this disease and recover from various extreme conditions, such as hurricanes and earthquakes.
3. Felinotherapy. Many people probably know that cats are the most affectionate animals, capable of calming and delighting after nervous tension. And a calm environment in the company of a cat has a positive effect on brain cells, allowing them to recover faster, which helps a speedy recovery.

Communication with such animals plays a therapeutic role and develops in a person a desire to care for and love animals.

general description

Aphasia is a disorder of speech function, expressed in the complete or partial loss of the ability to understand the speech of others and to use one’s speech apparatus.
At the same time, the native functions of hearing and articulation apparatus are preserved. Aphasia is characterized by the loss of an already formed speech function, which is formed in people from childhood, and not in situations where speech is not formed initially. Aphasia develops as a result of dysfunction of areas of the brain located in the left hemisphere and, in addition to speech activity, is accompanied by profound changes in the sensory, motor, and mental sphere of a person. Aphasia affects mainly adults, but it occurs extremely rarely in children. Being a complex disorder, aphasia requires the joint efforts of specialists from various clinical specialties for its treatment. Causes:

• diseases of cerebral vessels;
• brain injuries;
• neuroinfections;
• long-term diseases of the central nervous system with a tendency to progress.

Risk factors for aphasia:

• elderly and senile age;
• hereditary predisposition;
• atherosclerotic vascular lesions;
• arterial hypertension;
• aggravated neurological status.

The severity of speech disorders is determined by many components, including: the topic and area of ​​focus of the lesion, its cause, the age factor, the background state of health. Aphasia most often develops in people who have suffered a stroke; every third patient suffers from it.

Consequences and complications

If aphasia is not treated, then the very first and most terrible complication is the complete absence of speech, the inability to write, read and understand the speech of others. If acoustic-gnostic aphasia occurs in a child aged 5 to 7 years, this can lead to a terrible complication in the form of a complete absence of speech or further gross changes in speech development. Unexpectedly, this relief of motor aphasia leads to stuttering.

If this pathology is not treated for a long time, it subsequently leads to the following consequences:

• Development of irreversible speech defects;
• Difficulty adapting to society, the patient becomes an outcast;
• Death.

Be sure to remember that sensory aphasia is a dangerous brain disorder that requires treatment. This problem is considered only a consequence of a more terrible disease, which always requires a long course of treatment, and sometimes surgery.

Motor aphasia

Broca's motor aphasia

is a violation of the ability to speak while maintaining the ability to understand speech. Occurs when the frontal lobe of the brain (Broca's motor speech center) is damaged. The patient has difficulty pronouncing or does not pronounce words, mainly pronouncing simple words or syllables. The main features of the form of motor aphasia are:

• the patient’s speech is poorly distinguishable, but is often understandable and meaningful, accompanied by eloquent gestures (the patient has difficulty pronouncing and moving from one word to another)
• the speech of others is well understood by the patient