Eng. 511 A paper presented to: Prof. Mohammad Kebbe.. By: Nasreen Al-Twa resh.. !"5""1#$1.. 1st term..

1!"%..

"Aphasia": definition & causes..

Twairesh, N.

Aphasia (from Greek , privative, and !", speech# is a term which means $itera$$% ina&i$it% to speak, and is used to denote various defects in the comprehension and e'pression of &oth spoken and written $an(ua(e which resu$t from $esions of the &rain ()ikipedia#. *n other words, aphasia is a communication condition that resu$ts from dama(e to the $an(ua(e areas of the &rain+ a disorder which $imits the comprehension and e'pression of $an(ua(e. *t is an ac,uired impairment due to &rain in-ur% in the $eft cere&ra$ hemisphere. .phasia is defined &% )e&ster/s 0ictionar% as a "$oss or impairment of the power to use or comprehend words usua$$% resu$tin( from &rain dama(e." The most common cause of aphasia is a stroke or &rain attack which occurs when the &$ood supp$% to the &rain is interrupted. 1ther causes are &rain tumors, head in-ur%, or other neura$(ic i$$nesses. .n%one can ac,uire aphasia, &ut most peop$e who have aphasia are in their midd$e to $ate %ears. 2en and women are e,ua$$% affected. 3rimar% si(ns of the disorder inc$ude difficu$t% in e'pressin( onese$f when speakin(, difficu$t% with readin( and writin( and trou&$e understandin( speech. .phasia is not a disease, &ut a s%mptom of &rain dama(e.

T%pes of aphasia:
There are man% s%mptoms that indicate aphasia. These inc$ude: ina&i$it% to comprehend speech, ina&i$it% to write (agraphia#, ina&i$it% to read (alexia#, ina&i$it% to form words, ina&i$it% to name o&-ects (anomia#, poor enunciation, e'cessive creation and use of persona$ neo$o(isms (jargon aphasia#, ina&i$it% to repeat a

Twairesh, N.

phrase, persistent repetition of phrases, ina&i$it% to speak 5without musc$e para$%sis5 and other $an(ua(e impairment. There are man% different s%stems for c$assif%in( aphasia and man% different t%pes of aphasia within each s%stem. 6ome s%stems are main$% &ased on the $ocation of the $esion. 1thers are &ased on the person/s &ehavior. The common types of aphasia are: 1. Broca's aphasia (expressive aphasia): This t%pe is a$so known as non5f$uent aphasia. 3eop$e with this t%pe of aphasia have difficu$t% communicatin( with others ora$$% and and in written. 7roca/s aphasia is ca$$ed expressive aphasia &ecause the aphasic knows what he wants to sa% &ut is not a&$e to sa% or e'press it with words.3eop$e with this t%pe of aphasia often have trou&$e performin( the motor or output aspects of speech. Thus, it is a$so known as "motor" aphasia. 3eop$e with 7roca/s aphasia have dama(e to the fronta$ $o&e of the &rain. These aphasics fre,uent$% speak in short, meanin(fu$ phrases that are produced with (reat effort and the% often omit sma$$ words such as "is," "and," and "the". The% often have ri(ht5sided weakness due to the fact that the fronta$ $o&e is a$so important for the movement of the &od%. 3atients with this t%pe of aphasia fre,uent$% e'perience depression since the% t%pica$$% have (reat awareness of their deficits. 8Nei(h&orhood si(ns inc$ude &uccofacia$ (&ut not $im&# apra'ia and ri(ht hemiparesis invo$vin( the face and arm more than the $e(.9 (e2edicine#

Twairesh, N.

2. Wernicke's aphasia (receptive aphasia) This t%pe invo$ves difficu$t% understandin( spoken or written $an(ua(e. The aphasic can hear the voice or see the print &ut is not a&$e to make sense of the words. 3atients with )ernicke/s aphasia have impaired repetition &ut have more f$uent speech than patients with 7roca/s aphasia. 0espite the f$uenc%, speech is fu$$ of emptiness and (i&&erish 8-ar(on speech.9 ;omprehension is impaired. Grammar is &etter preserved than in 7roca/s aphasia. )ernicke/s aphasia is caused &% dama(e to the tempora$ $o&e. 6uch aphasics usua$$% have no &od% weakness &ecause their &rain in-ur% is not near the parts of the &rain that contro$ movement. 8*n )ernicke/s aphasia, nei(h&orhood si(ns inc$ude a superior ,uadrantanopsia due to invo$vement of optic radiations+ $im& apra'ia due to invo$vement of the inferior parieta$ $o&u$e+ fin(er a(nosia, aca$cu$ia, or a$e'ia with a(raphia+ and components of the so5ca$$ed 8Gerstmann s%ndrome9 due to invo$vement of the an(u$ar (%rus.9 (e2edicine# 3. Nomina aphasia (anomic aphasia) This form of aphasia ma% &e the resu$t of a recovered aphasia of another aphasia t%pe. <owever, true anomic aphasia is its own aphasia t%pe. The cause of this t%pe cou$d &e $esions in mu$tip$e &rain areas, inc$udin( a $esion in the dorso$atera$ fronta$ corte', posterior temporo5occipita$ corte', or tha$amus. . $eft anterior tempora$ $esion a$so can cause anomic.This t%pe is considered the $east severe form of aphasia. 3eop$e sufferin( from this t%pe have difficu$t% in findin( and usin( the correct names for certain peop$e, o&-ects, p$aces or events.

Twairesh, N.

!. " o#a aphasia This t%pe resu$ts from e'tensive and severe dama(e to the $an(ua(e areas of the &rain. The aphasic suffers from a$most tota$ $oss of ver&a$ or written $an(ua(e a&i$it%. <e cannot speak or understand speech, nor can he read or write. 2an% patients with ($o&a$ aphasia are ,uite proficient at makin( their needs understood without producin( spoken or written speech. 6ome of the wa%s in which patients with ($o&a$ aphasia ma% communicate successfu$$% inc$ude prosod%, inf$ection, pointin(, and e'pressions of approva$ or disapprova$. >ecover% in the first ? months (enera$$% outpaces $ater recover%+ however, some patients can recover function %ears after the initia$ in-ur%. $. %on&'ction aphasia 8;onduit d/approche9 refers to an attempt to correct errors. This t%pe is a$so ca$$ed associati(e aphasia. *t is a re$ative$% rare form of aphasia and resu$ts from dama(e to the nerve fi&res in the arcuate fascicu$us, which connects )ernicke/s and 7roca/s areas. *n this t%pe, aphasics/ $an(ua(e output is f$uent &ut namin( and repetition are impaired. 3atients with conduction aphasia ma% have a remarka&$e written comprehension+ cases of patients with conduction aphasia who read nove$s have &een reported. <esitations and word5findin( pauses are fre,uent in such aphasics. The parts of the &rain affected in conduction aphasia are the supramar(ina$ (%rus and the an(u$ar (%rus. 8Nei(h&orhood si(ns inc$ude superior ,uadrantanopsia+ if the $esion undercuts the parieta$ $o&e, $im& apra'ia, which is t%pica$$% more disa&$in( and $ess often dia(nosed than the aphasia itse$f, ma% &e present. These nei(h&orhood deficits

Twairesh, N.

c$ose$% resem&$e those seen in )ernicke aphasia. 6uch nei(h&orhood si(ns are not invaria&$e.9 (e2edicine# A fe) ess common types inc '&e: 1. Transcortical aphasias: Transcortica$ motor aphasia This t%pe resu$ts from an in-ur% to the anterior superior fronta$ $o&e. 3eop$e sufferin( from this t%pe of aphasia usua$$% have (ood comprehension %et the% e'perience effortfu$ and ha$tin( "non5f$uent" speech as a resu$t of dama(e to the fronta$ $o&e. The speech of such aphasics is usua$$% one or two words $on(. This t%pe is caused &% anterior cere&ra$ arter% stroke and has associated $e( weakness. Transcortica$ sensor% aphasia 3atients can produce f$uent speech &ut do not understand fu$$%, cannot name, or $ose semantic associations of speech. This kind of aphasia is a resu$t of dama(e to a re(ion known as the Tempora$5occipita$5parieta$ -unction, $ocated &ehind )ernicke/s area. This t%pe is empt% speech with short circum$ocutor% phrases predominatin(. *t is t%pica$$% seen in advancin( .$Aheimer disease and other pro(ressive dementias. 2i'ed transcortica$ aphasia: .phasics can repeat what is said &ut can neither produce speech nor understand it. This t%pe is a$so ca$$ed iso$ation of the speech area. 2. Subcortical aphasias:

Twairesh, N.

 6u&cortica$ motor aphasia 6u&cortica$ sensor% aphasia 3. Acquired eleptiform aphasia (Landau leffner S!ndrome" This is a rare t%pe of aphasia. The s%mptoms &e(in in chi$dhood and pro(ress. The s%ndrome is treata&$e, a$thou(h in some cases the seiAures are contro$$ed more than the aphasia.

Aphasia Aphasia, unable to repeat sentence

Type Expressive (Broca) $eceptive (%ernic&e) Con"uction *lobal Speech Non luent 'luent 'luent Non luent Comprehension !oo" poor !oo" poor Localization Lo#er posterior rontal (osterior superior temporal )sually parietal operculum Lar!e perisylvian lesion

Aphasia, able to repeat sentence #ell

Type Speech Comprehension Localization Anterior to Broca+s area or supplementary speech area Surroun"in! %ernic&e+s area posteriorly both o the above An!ular !yrus or secon" temporal

Tanscortical motor

Non luent

!oo"

Transcortical sensory Transcortical mixe" Anomic

'luent

poor

Non luent 'luent

poor !oo"

Twairesh, N.

!yrus

6ource: http:CCneuro$and.comCsandsCaphasia.htm

<ow is aphasia treatedD

The kind of treatment the patient under(oes is determined &% the ph%sician &ased on a num&er of factors inc$udin(: patient/s a(e, overa$$ hea$th, and medica$ histor%, e'tent of the disorder, patient/s to$erance for specific medications, procedures, or therapies, e'pectations for the course of the disorder and patient/s opinion or preference. There are some studies that test how dru(s can &e used a$on( with speech therap% to improve recover% of various $an(ua(e functions. ;omputers are used in other approaches to improve the $an(ua(e a&i$ities of aphasics. ;omputer5assisted therap% can he$p peop$e with aphasia retrieve and produce ver&s. .mon( the factors that affect the de(ree of improvement are the cause of the &rain dama(e, the area of the &rain that was dama(ed, the e'tent of the .in-ur%, and the person/s (enera$ hea$th

%here can , !et a""itional in ormationAmerican *peech+,an-'a-e+.earin- Association (A*.A) 1EFE1 >ockvi$$e 3ike >ockvi$$e, 20, 4EF@4 Goice: (:E1# FHB5@BEE To$$5free Goice: (FEE# ?:F5F4@@, F::E a.m. 5 @ p.m., Iastern time TTJ: (:E1# FHB5E1@B Ka': (:E1# @B15E=@B I5mai$: actioncenterLasha.or( *nternet: www.asha.or(

Twairesh, N.

Brain /n0'ry Association of America F4E1 Greens&oro 0rive, 6uite ?11 2cMean, G., 441E4 Goice: (BE:# B?15EB@E To$$5free Goice: (FEE# ===5?==:, H a.m. 5 @ p.m., Iastern time Ka': (BE:# B?15EB@@ I5mai$: fami$%he$p$ineL&iausa.or( *nternet: www.&iausa.or( 1aster *ea s2 /nc. 4:E )est 2onroe, 6uite 1FEE ;hica(o, *M, ?E?E? Goice: (:14# B4?5?4EE To$$5free Goice: (FEE# 4415?F4B, F::E a.m. 5 @ p.m., ;entra$ time TTJ: (:14# B4?5=4@F Ka': (:14# B4?51=H= I5mai$: infoLeastersea$s.com *nternet: www.eastersea$s.com Nationa Aphasia Association (NAA) 4H Nohn 6treet, 6uite 11E: New Jork, NJ, 1EE:F To$$5free Goice: (FEE# H445=?44, H a.m. 5 @ p.m., Iastern time Ka': (414# 4?B54F14 I5mai$: naaLaphasia.or( *nternet: www.aphasia.or( American Aca&emy of Ne'ro o-y 1EFE 2ontrea$ .venue 6t. 3au$, 2N @@11? Goice: (?@1# ?H@51H=E *nternet: www.aan.com American .eart Association B4B4 Greenvi$$e .venue 0a$$as, TO B@4:1 Goice: (FEE# 4=45FB41 *nternet: www.americanheart.or( Nationa *troke Association HBEB Iast Iaster Mane In($ewood, ;1 FE114 To$$5free: (FEE# BFB5?@:B *nternet: www.stroke.or( http:CC??.41F.?H.11CsearchCcacheDpPaphasiaQ:.RnewRt%pes&smPJahoo Q41R6earch&to(($eP1&eiPSTK5

Twairesh, N.

F&uPwww.nidcd.nih.(ovChea$thCvoiceCaphasia.asp&wPaphasiaRnewRt%pes&dPT$*: G)KSM-pn&icpP1&.int$Pus

6ources:
http:CCserendip.&r%nmawr.eduC&&CneuroCneuroHHCwe&1COion(.htm$ http:CCwww.emedicine.comCNIS>1Ctopic=:B.htm http:CCen.wikipedia.or(CwikiC.phasia http:CCwww.ninds.nih.(ovCdisordersCaphasiaCaphasia.htm http:CCwww.sci.uidaho.eduCmed@:4C7roca.htm http:CCwww.umm.eduCentCaphasia.htm http:CCseniorhea$th.a&out.comC$i&rar%CstrokeC&$aphasia4.htm http:CCwww.wron(dia(nosis.comCaCaphasiaCsu&t%pes.htm http:CCwww.aphasia.tvC

Twairesh, N.

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