aphasia
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Introduction
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
- major syndromes
- minor central aphasia syndromes
- other syndromes
Etiology
- posterior lesions on convexity of left cerebral hemisphere (fluent aphasia)
- 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]
prognosis
- initial aphasia severity is the best predictor of speech & language recovery after ischemic stroke[7]
- lesion characteristics influence recovery
- lesion size: larger lesions correlate with worse outcomes[8]
- lesion location: lesion in the left posterior superior temporal gyrus & superior longitudinal fasciculus predict poorer naming outcomes
- damage throughout the middle cerebral artery distribution or temporoparietal area is associated with persistent deficits
- frontal lesions often show good recovery
More general terms
More specific terms
- 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
Additional terms
References
- ↑ nlmpubs.nlm.nih.gov/hstat/ahcpr/
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 158-16
- ↑ Cummings, Hospital Practice, May 1993, pg 56-68
- ↑ Rothaus C A Woman with Progressive Loss of Language. NEJM Resident 360 clinical pearls. Jan 11, 2017 https://resident360.nejm.org/content_items/2170/
- ↑ 5.0 5.1 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: https://pubmed.ncbi.nlm.nih.gov/30128538 https://jamanetwork.com/journals/jamaneurology/fullarticle/2696529
- ↑ Benghanem S, Rosso C, Arbizu C et al Aphasia outcome: the interactions between initial severity, lesion size and location. J Neurol. 2019 Jun;266(6):1303-1309. PMID: https://pubmed.ncbi.nlm.nih.gov/30820740
- ↑ 7.0 7.1 Gerstenecker A, Lazar RM. Language recovery following stroke. Clin Neuropsychol. 2019 Jul;33(5):928-947. PMID: https://pubmed.ncbi.nlm.nih.gov/30698070 PMCID: PMC8985654 Free PMC article. Review. https://pmc.ncbi.nlm.nih.gov/articles/PMC8985654/
- ↑ 8.0 8.1 Wilson SM, Entrup JL, Schneck SM et al Recovery from aphasia in the first year after stroke. Brain. 2023 Mar 1;146(3):1021-1039. PMID: https://pubmed.ncbi.nlm.nih.gov/35388420 PMCID: PMC10169426 Free PMC article.
- ↑ Harvey DY, Parchure S, Hamilton RH. Factors predicting long-term recovery from post-stroke aphasia. Aphasiology. 2022;36(11):1351-1372. PMID: https://pubmed.ncbi.nlm.nih.gov/36685216 PMCID: PMC9855303 Free PMC article. https://pmc.ncbi.nlm.nih.gov/articles/PMC9855303/
- ↑ NINDS Aphasia Information Page (Access Denied April 23 2026) https://www.ninds.nih.gov/Disorders/All-Disorders/Aphasia-Information-Page