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aphasia

The loss of ability to communicate orally, through signs, or in writing, or the inability to understand such communications; the loss of language usage ability. Classification: 1) major syndromes a) global aphasia b) Broca's aphasia c) Wernicke's aphasia 2) minor central aphasia syndromes a) conduction aphasia b) auditory aphasia (pure word deafness) c) visual aphasia (dyslexia with dysgraphia) 3) other syndromes a) pure word blindness b) isolation of speech areas c) amnesic-dysnomic aphasia d) transcortical motor aphasia e) transcortical sensory aphasia f) Landau-Kleffner syndrome (acquired epileptiform aphasia) g) primary progressive aphasia variant of - frontotemporal dementia, Alzheimer's disease, stroke Etiology: 1) posterior lesions on convexity of left cerebral hemisphere (fluent aphasia) 2) anterior lesions on the convexity of the left hemisphere (nonfluent aphasia - reserved speech with intact information) Pathology: - left anterior temporal lobe is specialized for word comprehension (recognition) Differential diagnosis: - delirium: pattern of language deficits is more specific than slurred speech & anomia associated with delirium - also see comparision of principal aphasic syndromes Management: - speech therapy - transcranial direct current stimulation may be useful for treatment of aphasia after stroke [5]

Related

comparision of principal aphasic syndromes language assessment paraphasia

Specific

amnesic-dysnomic aphasia (anomic aphasia) auditory aphasia Broca's aphasia (non-fluent aphasia) conduction aphasia global aphasia isolation of speech areas primary progressive aphasia (PPA, progressive non-fluent aphasia, PNFA) pure word blindness transcortical motor aphasia transcortical sensory aphasia visual aphasia Wernicke's aphasia; fluent aphasia; garbled speech

General

language impairment; linguistic dysfunction

References

  1. nlmpubs.nlm.nih.gov/hstat/ahcpr/
  2. Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 158-16
  3. Cummings, Hospital Practice, May 1993, pg 56-68
  4. Rothaus C A Woman with Progressive Loss of Language. NEJM Resident 360 clinical pearls. Jan 11, 2017 https://resident360.nejm.org/content_items/2170/
  5. Fridriksson J, Rorden C, Elm J et al Transcranial Direct Current Stimulation vs Sham Stimulation to Treat Aphasia After Stroke. A Randomized Clinical Trial JAMA Neurol. Published online August 20, 2018. PMID: 30128538 https://jamanetwork.com/journals/jamaneurology/fullarticle/2696529
  6. National Institute on Deafness & Other Conditions (NIDCD) http://www.nidcd.nih.gov/health/voice/aphasia.asp
  7. NINDS Aphasia Information Page https://www.ninds.nih.gov/Disorders/All-Disorders/Aphasia-Information-Page