Studied by 14 people
Chapter 3 & 4
Name & describe the three primary stages of seizure
Aura: Immediately before the full onset of a seizure. With warning signs preceding a seizure.
Ictus: The main stage of the seizure, with symptoms such as convulsions and possible loss of consciousness.
Post-ictus: The recovery period after a memory loss, characterized by confusion, drowsiness, weakness, depression, headache, nausea, and fatigue.
What is the term that describes a state of constant seizure
Status epilepticus: seizures one after the other without an interictal period are very severe and life-threatening.
What is a seizure?
A sudden, often periodic, abnormal level of electrical discharge occurring within the brain.
What is syphilis, what organism causes this disease, and what are some ways it can affect speech, language or cognition?
Syphilis is a sexually transmitted disease that is caused by the corkscrew-shaped bacteria called spirochetes. It is highly treatable with the antibiotic penicillin.
Syphilis may affect speech, language, and cognition by causing facial weakness, cognitive deficits, motor problems, and involvement of individual cranial nerves.
How might HIV/AIDS affect, speech, language, or cognition.
Speech Disfluent speech
Language: Although the language is often unaffected, mild to severe language deficits and severe in functional language deficits can be present
Cognition: Most common neurocognitive changes include:
impairments in the ability to learn new information
disfluent speech
loss of gross and fine motor abilities
gait disturbances
reduced attention abilities
slowness in processing information and
impaired recall
List of symptoms of Creutzfeldt-Jakob disease
Symptoms of Creutzfeldt-Jacob disease include
dementia with rapid onset
involuntary movement disturbances.
behavioral abnormalities
emotional volatility in the form of inappropriate
anger or
crying,
and “irrelevant” talk.
Later leads to developed slurred speech, gait abnormalities, and excessive sleepiness
How are simple partial seizures and complex partial seizures different?
Simple partial seizures are limited to a small area in one cerebral hemisphere, and the individual remains conscious.
A complex partial seizure is when a seizure occurs over a larger section of a single cerebral hemisphere and creates an altered state of consciousness.
How are generalized seizures different from partial seizures?
Partial seizures affect a localized portion of the brain.
Generalized seizures affect the entire brain and are associated with total loss of consciousness or awareness.
How might a benign tumor cause damage to the brain?
It can cause damage to the brain because it can cause mass effect.
If surgery is needed to remove the benign tumor, surgical trauma can itself be damaging and produce more complications and deficits than the tumor itself. Additionally, the tumor may produce focal damage within the brain that occurs and worsens gradually over time as the tumor grows.
What is encephalitis? Give one example and what its effect on speech, language or cognition might be.
Encephalitis is a general term for an acute inflammatory/ and or infection of the brain or spinal cord
An example of encephalitis and its effect on speech, language, or cognition is encephalitis lethargica. This causes inflammation and damage to subcortical structures, such as the sleep/wake cycle, heart rate, breathing rate, and control of movement. Those with this type of encephalitis usually present with symptoms similar to Parkinson’s disease.
What is an aneurysm, and why is having one dangerous?
DEFINITION: is an abnormal stretching and ballooning of the wall of a blood vessel.
It is dangerous because once a cerebral aneurysm ruptures, it becomes a hemorrhagic stroke with a sudden and rapid spilling of blood into the brain. Ruptured aneurysms tend to be deadly, and most of the individuals who survive have some form of permanent disability.
What are the 2 main forms of hemorrhagic stroke, and how do they differ?
subarachnoid hemorrhage is a bleed that occurs between the surface of the cerebrum and the skull.
Specifically, the hemorrhage occurs in an area known as the subarachnoid space that exists between the arachnoid mater and the pia mater, which overlay and protect the cerebrum.
intracerebral hemorrhage occurs when a blood vessel bursts within the brain itself.
How do primary tumors and secondary tumors differ?
A primary tumor is an abnormal mass of tissue that originates within the brain.
A secondary tumor is a cancerous mass of tissue that has spread from another part of the body to the brain.
DIFFERENCE: primary tumors stay in the location they originate and are not necessarily cancerous, while secondary tumors spread throughout the body and are always cancerous.
What are the 3 main forms of ischemic strokes, and how do they differ?
Thrombus stroke: a thrombus that forms slowly on the walls of an artery and interrupts blood flow to the brain, resulting in a stroke. Usually is the result of atherosclerosis; the buildup of fatty materials in the blood, narrowing walls of arteries and restricting blood flow.
Embolic stroke: occurs when a mass such as a blood clot originates in the body and travels through the vascular system (embolus) to the brain and lodges in a blood vessel, restricting or cutting off blood circulation within the brain. Extra: A piece of thrombus can become an embolus if it breaks off an arterial wall and travels elsewhere within the brain to lodge and create an occlusion within a blood vessel.
Transient ischemic attack (AKA: TIA/mini stroke): It is a small ischemia within the brain that resolves within 24 hours. Individuals affected can present mild motor and cognitive deficits that go away when the blood clot causing the ischemia is successfully broken down by the body. Typically, no permanent deficits or life-threatening health issues. Sign of a larger more destructive stroke to come.
Why is having the ischemic penumbra a priority for medical professionals?
The penumbra is important because, whereas the core has experienced permanent tissue damage, the tissue within the penumbra can often be salvaged with prompt and appropriate medical treatment. Damage within the ischemic penumbra can typically be reversed within 2 to 4 hours of onset of ischemia.
This means that with timely medical intervention, the brain tissue within the penumbra can be saved. Saving the penumbra improves the short-term and long-term prognoses for the patient.
Why are some etiologies called idiopathic?
An etiology is the underlying medical cause of a symptom or deficit.
Some etiologies are called idiopathic if its underlying cause, or etiology, is unknown or obscure.
Compare and Contrast how ischemic and hemorrhagic strokes damages the brain
Ischemic strokes occur when a blood vessel supplying blood flow to the brain is occluded or blocked. This blockage deprives the brain tissue of blood supply necessary to survive.
In contrast, hemorrhagic strokes occur when a blood vessel within the brain ruptures and interferes with the brain's ability to function. Three mechanisms of damage to the brain are possible with hemorrhagic strokes.
First, the blood supply to a portion of the brain is interrupted as a result of the broken or burst blood vessel.
Second, the blood from the hemorrhaged vessel spills outside the circulatory system into the brain and damages the tissue it comes into contact with.
Third, intracranial pressure increases because of the continued release of blood into the brain or between the skull and the cranium.
How are tonic-clonic seizures different from petit mal seizures?
Petit mal seizures are generalized sudden abnormal levels of electrical discharge in the brain in which an individual loses awareness for a few seconds and might seem simply to stare off into space before coming to. There is no gross motor activity, shaking, or convulsing as seen in petit mal seizures
During a tonic-clonic seizure, the individual passes through a stage of muscle contraction and loss of consciousness followed by a stage of abnormal motor activity.
Describe how you would assist or help a person experiencing a tonic-clonic seizure
If they are showing signs, help get them on the floor as soon as possible to minimize damage associated with a fall. Supporting their head with something soft like a pillow can offer further support. Other helpful things include not putting anything in their mouth, clearing away sharp or dangerous objects, turning them on their sides to keep saliva from falling into the airway, and staying with the individual until the seizure ends or until medical personnel arrive. Do not try to restrict their movements.
How might a lesion at the striatum be associated with aphasia?
A lesion at the striatum might be associated with aphasia because infarcts that damage the striatum can also disrupt blood flow to the primary language cortices that are enough
to create an aphasia, but not enough for the immediate cell death to show up on neuroimaging studies used in hospitals.
Detail two subcortical aphasias, their lesion location(s), and signs and symptoms of each.
Thalamic Aphasia: The lesion location is on the left or dominant side of the thalamus.
Some signs and symptoms include: almost fluent speech, significant anomia in spontaneous speech but less so in confrontational naming tasks, impaired receptive language, perseverative semantic paraphasias, normal articulation, hypophonic voice, intact repetition, and intact grammar.
Striatocapsular Aphasia: The lesion location is within a part of the basal ganglia known as the striatum.
Some signs and symptoms include: loss of fluency, rare phonemic paraphasias, preserved repetition.
What should be included during an aphasia assessment? Why is each component important?
In an aphasia assessment, this usually includes an in-depth case history, assessing functional communication and connected speech, administering a standardized test of aphasia, evaluating cognition, and assessing quality of life.
The case history is important because it has the basic demographics, medial
history, and social history of the patient, which sets the context for interpreting all other information gathered.
Assessment of functional communication and connected speech: that is obtained through a patient and family interview is also important because it gives the SLP the opportunity to assess the patient’s residual language abilities to communicate in functional situations that could be later used as a baseline.
Administration of a standardized test of aphasia: assesses multiple modalities of language, including verbal reception of language, verbal expression, reading, and writing, which allows for confirmation, refutation, and triangulation of preliminary conclusions to set goals and prognosis.
Evaluation of cognition: An evaluation of cognition is important because cognition, language, and communication are intimately intertwined. Some level of cognition deficit is almost universally present in those with aphasia.
Explain the role of the arcuate fasciculus in conduction aphasia
The role of the arcuate fasciculus is to connect Broca’s area and Wernicke’s area to transfer information from the temporal lobe (language heard) to the frontal lobe for direct repetition.
In conduction aphasia, this pathway is damaged; therefore, disconnection of posterior areas of the brain from more anterior areas inhibits repetition abilities.
Detail the four cortical fluent aphasias, their lesion location(s), and signs and symptoms of each.
Wernicke’s aphasia: occurs when there is a lesion in Wernicke’s area in the left hemisphere. If the lesion reaches posteriorly toward the angular gyrus and into the visual association cortex, there may be reading deficits. The signs and symptoms for Wernicke's aphasia are fluent, but nonsensical speech filled with neologisms, significant impaired receptive language deficits, comprehension deficits, impaired repetition, anosognosia, deficits in pragmatic skills, and logorrhea.
Transcortical Sensory Aphasia: lesion posterior to Wernicke's area is located in the temporo-occipital- parietal junction. The symptoms are poor auditory comprehension, relatively intact repetition, and fluent speech with semantic paraphasias.
Conduction Aphasia: lesion on the supramarginal gyrus, posterior to the primary sensory cortex, above Wernicke’s area that damages the arcuate fasciculus. The symptoms for conduction aphasia are fluent speech, relatively intact auditory comprehension, poor repetition, and phonemic paraphasias, anomia, ability to paraphrase.
Anomic Aphasia may occur when there is damage anywhere within the language areas. The symptoms are severe word-finding difficulties, intact comprehension/receptive language, fluent speech, and repetition.
How might self-repairs produced by a person with aphasia reduce fluency?
Too many unsuccessful self-repairs break up fluency of an utterance and do not contribute to appropriate communication.
What are three cognitive and three motor deficits that can co-occur with aphasia?
Motor deficits
Dysarthrias
Apraxia of speech
Dysphagia
Cognitive:
Arousal
Attention
Short-term memory
Why is communication partner training important?
Communication partner training is important because the spouses or caregivers who communicate the most with the individual with aphasia do not realize how best to communicate or facilitate overall communication with their partner.
How does group therapy facilitate hope and recovery?
Group therapy facilitates hope and recovery because it promotes hope, psychosocial emotional support, pragmatics, self-confidence, and carryover from individual therapy sessions.
Why is neuroplasticity important to aphasia rehabilitation?
It is central to the concept of restorative therapy, since neuroplasticity allows a part of the brain to change its previous function to take on and learn a new and previously unknown role.
How does aphasia therapy facilitate spontaneous recovery?
Therapy for aphasia during the time of spontaneous recovery facilitates even greater levels of recovery and cues further improvement past the levels achieved with spontaneous recovery alone by cueing the brain to reorganize itself following stroke to restore lost abilities.
How does constraint-induced therapy differ from errorless learning?
Constraint-induced therapy constrains a patient’s ability to compensate for deficits and forces the person to use the weakened skills to exercise and improve the areas of weakness.
Errorless learning focuses on reducing the number of errors produced by patients by setting the difficulty level of tasks very low so the client can succeed.
How might learned nonuse inhibit rehabilitation?
Learned nonuse might inhibit rehabilitation because the individual learns to compensate for a deficit by employing other intact abilities and, in doing so, ceases to exercise the physical or intellectual ability in which the deficit is present.
Define aphasia
An acquired deficit in language abilities resulting from damage to the brain. It is not the result of motor, intellectual, or psychological impairment. Aphasia results in difficulty with language production, language comprehension, or both that may occur in any or all modalities (spoken, written).
How are phonemic, neologistic, semantic, and unrelated verbal paraphasias different from one another?
Phonemic: is when the word produced is discernable and mostly correct, yet there are phoneme-level mistakes.
Neologistic: is when the word that is entirely different from the intended word and is mostly unintelligible.
Semantic: is when one word is substituted for another word that is similar in meaning
Unrelated verbal paraphrase: is when a substitution of a word that is unrelated in meaning to the intended word
Why is it useful to use a classification system for the aphasias?
to have a reference point for professionals to communicate information about patients. This enables standardization of knowledge and language among speech-language pathologists and streamlining of communication regarding patients’ language deficits
for the purpose of lesion localization, which helps identify aphasia symptoms based on specific lesion locations.
Detail the three cortical nonfluent aphasias, their lesion location(s), and signs and symptoms of each.
Broca’s aphasia
occurs from damage to the inferior posterior frontal lobe of the left hemisphere that may be restricted to Broca’s area or extend adjacent to Broca’s area.
have mostly intact receptive language abilities with deficits in repetition and expression.
The symptoms of Broca’s aphasia include halting, effortful, agrammatic, and telegraphic speech that is mostly content words; disfluent speech due to circumlocution and anomia; impaired prosody due to shortened. Length of utterances and the self-repairs; deficits in written language that are similar to their verbal output, which may be further hindered by hemiplegia or hemiparesis; and deficits in repetition
Transcortical motor aphasia
is a result of damage to the supplementary motor cortex or the area just anterior to Broca’s area.
Individuals with transcortical motor aphasia display mostly intact receptive language abilities and relatively intact repetition with deficits in expressive language.
Global aphasia
is a result of damage to a large area of the zone of language within the left cerebral hemisphere
Global aphasia is characterized by severe to profound deficits in expressive language, receptive language, and repetition.
What are three categories of aphasia therapy? Given an example of each.
The three categories of aphasia therapy are:
restorative therapy (constraint-induced aphasia therapy)
compensatory therapy (AAC)
social therapy (communication partner training)
How does Shuells stimulation therapy different from melodic intonation therapy?
Schuell’s stimulation therapy is the re-establishing of lost language abilities through the use of auditory stimuli to evoke a response.
Melodic intonation therapy is the use of intact melodic/prosodic processing of the right hemisphere to cue word retrieval and production in the left hemisphere.
List the cortical non-fluent aphasia
Broca’s aphasia
Transcortical motor aphasia
global aphasia
List the cortical fluent aphasia
Wernicke’s Aphasia
Transcortical sensory aphasia
conduction aphasia
Anomic aphasia
What are the 2 subcortical aphasias
Thalamic aphasia
Striatocapsular aphasia.
Aphasia therapy facilitates spontaneous recovery. Spontaneous recovery can occur up to __ ________postonset.
6 months
Note 
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