Neurogenic Language Disorders

what is aphasia

language impairment; includes disturbance of any or all language domains (speaking, comprehending spoken language, reading, writing)

aquired neurogenic language disorder

what are the most frequent causes of aphasia

stroke (#1 cause), TBI, brain tumors or inflammation

how do the left and right hemispheres contribute to language

left: logic, language, analytical thinking, supporting problem solving and reasoning abilities; linguistic info processed

right: creativity, spinal ability, intuition, rhythm, prosody, emotion detection; stores multiple meanings involved in language use, subtle inferencing and body language

what areas of the brain play significant roles in language (specifically broca’s and wernickie’s)

• Broca’s: incoming auditory info held in working memory; sends programming info to motor cortex which sends signals to motor neurons for speech

• Wernickie’s: most incoming linguistic processing

what is the difference between fluent (wernickie’s) and non-fluent (broca’s) aphasia

• fluent: speech produced with minimal effort, normal rate of speech (100-200 wpm), normal melodic properties, easy initiation, paraphsiacs (sound or word substitutions)

• Wernicke’s aphasia: fluent, difficulty with comprehension as well as production, shows less awareness of deficit

• non-fluent: effortful/labored speech, reduced rate of speech (less than 50 wpm), limited phrase length, abnormal prosody, difficulties with initiation of speech, excessive use of context and omission of function words

• Broca’s aphasia: non-fluent, agrammatism, affects function words more than context words

what are the clinical signs of right hemisphere language

visual spatial neglect and other attention deficits; issues with memory, difficulties with executive function such as problem solving, reasoning, organization, planning, and self awareness

communication problems: monotone voice, aprosodia, difficulty producing or comprehending affective (emotional) aspects of speech

disorganized speech: rambling and tangential

lack of social conventions, difficulty grasping overal significance of events

what is diffuse axonal injury

occurs when the brain experiences rapid acceleration or deceleration leading to widespread injury of nerve fibers (coup/contre coup)

damage to axonal fibers disrupts normal communication between different regions of the brain, affecting neurological function

often leads to coma or long term cognitive disabilities

what are some common issues that patients with TBI frequently struggle with

• diffuse axonal injury

• neurological/physical deficits: epilepsy, coordination, muscle weakness/paresis, sensory deficits

• cognitive/intellecutal deficits: memory and amnesia, decreased IQ, slower processing speed, attention, executive functioning, pragmatics

• emotional/behavioral issues: personality changes, awareness of deficits, self-monitoring, motivation or drive, impulsivity, aggressiveness, disinhibition, interpersonal skills, anxiety and/or depression

what are some common treatments strategies for dementia

• restore functions as possible

• help patient compensate for deficits (daily activiy log, write down important info)

• environmental adaptations (labels around house)

• alarms/trackers, memory book

• pictures combined with phone numbers, digital picture frames

• provide caregiver and assit caregiver in anticipation of patient’s wants and needs

describe the Medicare rules for treating dementia

Must be providing professional services, not just something that a caregiver could do

Must be functional