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    Aphasia After Stroke

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    Dr. JDP

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    Aphasia After Stroke

    Uploaded by

    Dr. JDP
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    APHASIA AFTER STROKE

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    5 views20 pages

    Aphasia After Stroke

    Uploaded by

    Dr. JDP

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    © All Rights Reserved
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    APHASIA’S AFTER

    STROKE
    BY Dr Deepak Prasad J
    1st year PMR PG
    APHASIA’S
    • WERNICKE’S
    • BROCA’S
    • GLOBAL
    • ANOMIC
    • CONDUCTION
    • TRANSCORTICAL MOTOR
    • TRANSCORTICAL SENSORY
    • TRANSCORTICAL MIXED
    ERRORS IN SPEECH
    • Paraphasia: Incorrect substitution of words or parts of words.
    • Agrammatism – absence of grammatical structure in a sentence.
    • Anomia – difficulty in recalling words.
    • Echolalia – repetition of words made by another person.
    • Neologism – a ‘new word’ that is well articulated but has meaning only to
    the speaker
    • Jargon – well articulated but mostly incomprehensible, unintelligible
    speech.
    WERNICKE’S APHASIA
    • Location: posterior part of superior
    temporal gyrus
    • Characteristics –
    • Fluent speech
    • Impaired comprehension
    • Marked paraphasias & neologisms
    • Word deafness, alexia, agraphia
    BROCA’S APHASIA
    • Location: posterior-inferior frontal lobe
    • Characteristics –
    • Non fluent speech
    • Impaired repetition
    • Preserved comprehension
    • Paraphasias & articulatory errors
    GLOBAL APHASIA
    • Location: vary in size and location { involves left MCA}
    • Characteristics –
    • Ranges from mutism to total repetitive jargon or neologistic
    output
    • Poor comprehension and repetition.
    ANOMIC APHASIA
    • Location: temporo-parietal injury, angular
    gyrus
    • Characteristics –
    • Fluent, good comprehension and
    repetition
    • Word finding difficulties
    • In order to overcome this difficulty, they
    use a technique called circumlocution.
    • Circumlocution is a strategy or
    technique used by patients with anomic
    aphasia in which they find the alternative
    words when they are unable to find the
    exact appropriate word (we can say they
    speak in a roundabout way).
    CONDUCTION APHASIA
    • Location: lesion of arcuate fasciculus or insula
    • Characteristics –
    • Normal rate of speech
    • Preserved comprehension
    • Impaired repetition
    • Inability to repeat the said words
    TRANSCORTICAL MOTOR
    APHASIA
    • Location: frontal lobe, ant/superior to
    broca’s area
    • Characteristics –
    • Reduced rate of speech, limited language
    output
    • Reduced initiation & organization of
    speech
    • Good comprehension; preserved
    repetition
    TRANSCORTICAL SENSORY APHASIA
    • Location: watershed lesion isolating perisylvian speech
    structures (Broca’s & Wernicke’s) from the posterior brain
    • Characteristics –
    • Poor comprehension
    • Fluent speech (neologisms)
    • Preserved repetition (possibly echolalia)
    TRANSCORTICAL MIXED APHASIA
    • Also known as isolation aphasia
    • Lesions in border zone of frontal,
    parietal, and temporal areas.
    • Characteristics –
    • Poor comprehension
    • Non fluent
    • Preserved repetition (echolalia)
    TREATMENT APPROACHES
    • Pharmacological
    • Non pharmacological
    PHARMACOLOGICAL
    • Memantine
    • Bromocriptine
    • Citicoline
    • Piracetam
    • Amphetamines
    • Donepezil
    NON PHARMACOLOGICAL
    • Loss versus interference
    • Direct versus indirect
    • Behavioural versus psycholinguistic
    • Programmed operant
    • Programmed instruction
    • AMERInd
    • MIT
    MELODIC INTONATION
    THERAPY(MIT)
    • Melodic Intonation Therapy (MIT) is an
    evidence-based treatment method that
    uses intoning (singing) to improve
    expressive language in people with
    aphasia.
    • The approach takes advantage of the
    undamaged right hemisphere by
    engaging areas that are capable of
    language
    • Useful in patients with Broca’s aphasia
    CANDIDATES FOR MIT
    • Have damage to only the left hemisphere of the brain
    • Demonstrate moderately good auditory comprehension
    • Have non-fluent speech with effortful speech production of only a few
    words or only nonsense syllables
    • Have poor ability to repeat even single words
    • Show some ability to produce words while singing familiar songs
    • Be alert, motivated, emotionally stable, and have a good attention span
    POST STROKE APHASIA
    RECOVERY
    • Maximum improvement occurs in the first 2-3 months after the
    onset
    • After 6 months, - drop in rate of recovery
    • In majority of cases with aphasia, spontaneous recovery does
    not seem to occur after 1 year.
    THANK YOU

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