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I don't know how to speak! I don't know what I'm saying! Aphasia and its therapy

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I don't know how to speak! I don't know what I'm saying! Aphasia and its therapy

Pantherstock

Love and support in older people

A disorder of the ability to speak and understand speech, which is caused by damage to the cortical speech centres in the brain, is called aphasia.

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What influences aphasia?

Thedamage that causes aphasia can be caused by a number of different factors, such as stroke, trauma, brain tumour or encephalitis. There is no aphasia in the case of paresis of the articulatory muscles, the tongue or loss of feeling in these areas of the body if there is no brain damage. In this case, we speak of dysarthria.

Damage to the cerebral cortex and/or subcortical structures such as the thalamus, the basal nucleus or damage to the white matter can cause aphasia symptoms. These symptoms are a clear indication of brain damage and are therefore the basis for a diagnosis of central nervous system damage.

Expressive (motor) aphasia

It was described by the surgeon and anthropologist Paul Broca in 1861, who located the cortical motor speech centre (which today is called Broca's area) in the frontal lobe of the brain. He described the symptoms that are supposed to occur when damage occurs to this part of the brain, but today's research indicates that for all the symptoms he described to occur, there would have to be damage not only to the centre he was talking about but to a much larger part of the brain. This type of aphasia is also called non-fluent aphasia. This is due to the fact that if speech does not disappear completely, it takes a lot of effort to produce it and is usually produced in the form of syllables. There is therefore a problem with speech generation. Poor and often distorted speech is characteristic.

Receptive (sensorineural) aphasia

This was described by Carl Wernicke in 1874. This doctor pointed out a different problem, namely people who spoke completely normally, but understood neither their own speech nor the speech of other people. Here, the problem found was damage to the lateral surface of the temporal lobe (today this area is called Wernicke's area). This type of aphasia is a fluent disorder, meaning that it is not the fluency or technique of speech that is affected, but rather the content, which remains inconsistent with meaning, meaningless, full of neologisms and distortions.

Most often, however, aphasia is of the mixed type, where there are problems with both the generation of speech and the meaningfulness of the spoken content.

Aphasia, Brain-damage, Neurologist

Aphasia, photo: panthermedia

A diagnosis is necessary before therapy can begin. Both diagnosis and therapy are carried out by a neurologist. The therapy should be pragmatically orientated and address the patient's problems holistically.

When the aphasia problem is compounded by paralysis, e.g. of the upper limb, it is necessary to involve the other limb by activating it for writing (using a typewriter or computer, for example). When the paralysis is too severe, communication with the patient relies on head movements. The alphabet is broken down and the carer, pointing to the individual letters, puts words together. It is important here to establish a list of the most frequently used words.