NS72: Aphasia Syndromes

  1. What is aphasia?
    a disorder of language, acquired secondary to brain damage
  2. What is dysphasia?
    congenital language disorder
  3. What is speech?
    articulation and phonation of language sounds
  4. What are 4 disorders that commonly affect content of speech?
    • Schizophrenia
    • Neologisms new words
    • Word Salad cannot connect a patient's thoughts
    • Loose associations ideas expressed are unrelated
  5. What is the purpose of Wernicke's area?
    • for langague discrimination
    • is located in the posterior part of the left superior temproal gyrus (brodmann area 22)
  6. What does Broca's area do?
    • programs the neurons in adjacent motor cortex for larynx and mouth
    • important for repetition and spontaneous speech
  7. In Right Handed people, where is the dominant hemisphere for speech?
    the left hemisphere
  8. If you destroy the non-dominant hemisphere, you're likely to have many problems, what are soem of the speech problems you will have?
    • speech is flat and unemotional
    • loss of prosody or emotional intonation (robot sounding)
    • loss of emotional comprehension
    • stress and emphasis within sentences are affected
  9. What are the 8 steps to a bedside language examination?
    • 1. observation of speech and comprehension during the clinical interview
    • 2. follow-up examinations: good for stroke or tumor which could produce Wernicke's aphasia
    • 3. Describe the patient's speech: fluent vs. non-fluent, rate, prosody, errors
    • 4. Ask patient to name objects, object parts, pictures, colors *recall NIH Stroke pictures
    • 5. Auditory comprehension
    • 6. Repetitionof words and phrases "No ifs, ands, or buts" "methodist episcopal"
    • 7. Reading
    • 8. Writing
  10. What are the symptoms of Broca's Aphasia?
    • Speech is Non-Fluent
    • Omition of small grammatical words, but says principal words
    • Naming is impaired
    • Repetition is impaired
    • Reading is often impaired
    • comprehension is intact
    • most patients will have a right hemiparesis and right hemisensory loss
  11. What is lesioned in Broca's Aphasia?
    Broca's Area in posterior part of the inferior frontal gyrus (superior branch of MCA)
  12. What is the difference in onset between a large lesion and a small lesion in Broca's Aphasia?
    • large lesion initially causes global aphasia will resolution in Broca's Aphasia
    • small lesion initially causes Broca's Aphasia and resolves completely
  13. What would two findings of radiological origin be in Broca's Aphasia?
    • Image Upload 2
    • Image Upload 4
  14. What are the symptoms of Wernicke's Aphasia?
    • Wernicke's Aphasia is a receptive/sensory aphasia
    • Fluent speech
    • speech is empty of meaning with neologisms and paraphasic errors
    • naming is deficient
    • auditory comprehension is deficient
    • repetition is impaired
    • no hemiparesis or sensory loss
    • right (contralateral) partial or complete homonymous hemianopsia
  15. Where is the lesion in Wernicke's aphasia and what is the common cause?
    • Brodmann's Area 22
    • Inferior Division of the Left MCA
  16. What additional symptom will a patient suffer from in Wernicke's Aphasia if there is a disconnection from Broca's Area?
    impaired repetition
  17. What is the breakdown of Aphasia?
    Image Upload 6
  18. What are the common symptoms of Transcortical Motor Aphasia?
    • impaired fluency
    • normal comprehension
    • normal repetition
  19. What is the common cause of transcortical motor aphasia?
    • ACA-MCA watershed infact
    • Also caused by subcortical lesions involving BG or thalamus in the dominant hemisphere
  20. What are the symptoms of Transcortical sensory aphasia?
    • Fluent
    • impaired comprehension
    • intact repetition
  21. What are the symptoms of Mixed transcortical aphasia?
    • impaired fluency
    • impaired comprehension
    • intact repetition
  22. What causes transcortical sensory aphasia?
    • PCA-MCA watershed infactAlso caused by subcortical lesions involving
    • BG or thalamus in the dominant hemisphere
  23. What is the cause of mixed transcortical aphasia?
    • ACA-MCA and MCA-PCA watershed infact
    • Also caused by subcortical lesions involving
    • BG or thalamus in the dominant hemisphere
  24. Alexia without Agraphia
    • PCA infaction of occipital lobe of dominant hemisphere (lesion of posterior copus callosum)
    • Patient cannot read, but can write
  25. Gerstmann's Syndrome
    • lesion of dominant inferior parietal lobule and region fo the angular gyrus
    • agraphia, acalculia, right/left disorientation, finger agnosia (cannot name/identify fingers)
  26. What is Apraxia?
    • the inability to preform an action, not due to weakness or ataxia
    • some aphasia patients may have apraxia
  27. What are the 2 patterns seen in langauge with patients with dementia?
    • Pattern 1: reading adn writinga are first to deteriorate, conversations become simple, muteness (cocktail chatter)
    • Pattern 2: gradual progressive aphasia which gradually worsens
  28. What are the most common cause of aphasia?
    • Vascular lesionss, ischemic stroke
    • ALSO though, hemorrhagic stroke, tumors, neurodegenerative disorders, seizures (post-ictally as Todd's Phenomenon)
  29. When is the greatest recovery after a stroke for Aphasia?
    3 months
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NS72: Aphasia Syndromes
Neuroscience Week 7