Aphasia
From Ganfyd
Aphasia (perhaps better termed dysphasia) is an inability to comprehend and formulate language because of damage to the human brain. The damage will involve specific regions of the brain and is one of the common complications of a middle cerebral artery or anterior cerebral artery stroke where it will have sudden onset. It is open to intervention by speech rehabilitation in this last context, and from 2017 it is expected that increased resources will need to be identified over time to address the issue that traditional speech rehabilitation may not be intensive enough to provide optimal outcome for many affected stroke patients[1][2].
Impairment of the ability to produce (expressive aphasia) or comprehend (receptive aphasia) speech are the two classic divisions. Nominal aphasia is a form of expressive aphasia.
Expressive aphasia is different from dysarthria, where the words formed internally are correct, but the ability to articulate the words is impaired.
The further differential diagnosis of acute aphasia includes a long list of other left-hemisphere diseases (or right-hemisphere disease in true right hemisphere dominance) conditions. These include:
- Hemiplegic migraine
- Malignancy or other space occupying lesion
- Herpes simplex encephalitis
- Multiple sclerosis
- and many more causes encephalitis or cerebral damage
Progressive chronic aphasia over years has a more limited differential[3]:
- Creutzfeldt-Jakob disease, which rarely can cause a focal progressive aphasia that may evolve over a period of 3 or 4 years instead of the more typical 6 months to several years
- Primary progressive aphasia
- Usually due to frontotemporal lobar degeneration, especially with younger onset
- But Alzheimer's disease explains up to 40% cases.
References
- ↑ Breitenstein C, Grewe T, Flöel A, Ziegler W, Springer L, Martus P, Huber W, Willmes K, Ringelstein EB, Haeusler KG, Abel S, Glindemann R, Domahs F, Regenbrecht F, Schlenck KJ, Thomas M, Obrig H, de Langen E, Rocker R, Wigbers F, Rühmkorf C, Hempen I, List J, Baumgaertner A. Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting. Lancet (London, England). 2017 Mar.(Print-Electronic) (Link to article – subscription may be required.)
- ↑ Worrall L, Foster A. Does intensity matter in aphasia rehabilitation? Lancet (London, England). 2017 Feb.(Print-Electronic) (Link to article – subscription may be required.)
- ↑ Mesulam MM, Dickerson BC, Sherman JC, Hochberg D, Gonzalez RG, Johnson KA, Frosch MP. Case 1-2017. A 70-Year-Old Woman with Gradually Progressive Loss of Language. The New England journal of medicine. 2017 Jan; 376(2):158-167.(Print) (Link to article – subscription may be required.)
