09. Aphasia

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Aphasia [ 75 , 185 , 198 , 221 ] is a word of Greek origin meaning (loss of speech) [ 222 ]. It refers to the partial or total loss of the acquired ability to speak and / or understand the language, whether spoken or written, despite the anatomical and functional integrity of the organs of phonation (tongue, larynx) and independently any neurologic sensory origin (without hearing difficulties or view) or motor (primary motor cortex) [ 185 ].

1. Pathophysiology:

Aphasia occurs due to a lesion of the left hemisphere dominant for language. This lesion appears as a result of a breach of brain tumor, head trauma, or more often a cerebrovascular accident (CVA) [ 198 ].

Most people with aphasia do not completely lose the power of speech. Aphasia is a language disorder that can have significant nuances: some patients show only slight uncertainties to find their words, while others have almost completely lost the ability to speak, understand what said to them, read and / or write, while other faculties such as memory or orientation are preserved.

2. Classification:

There are several types of aphasia as underlying mechanisms and clinical translation of brain abnormalities [ 50 ]. However, aphasia can be classified into three broad categories [ 212 ]:

2.1. Sensory aphasia (Wernicke) [ 5 , 198 ]:

This type of aphasia is characterized by a lack of understanding of language, difficulty in interpreting the meaning of words and phrases. It is characterized by disorders of the very important understanding and verbal expression using inappropriate words, with the use of new vocabulary (neologism [ 50 ]). The patient is not aware of his involvement [ 223 ].

This type of aphasia occurs mainly at a lesion in the left air which affects the Wernicke hemisphere.

2.2. The motor aphasia (Broca) [ 49 ]:

Loss of speech, difficulty expressing ideas. It is characterized by disorders of oral and written while the understanding is quite good.

The patient generally has joint problems to varying degrees, and uses phrases that are not structured. It's hard to find the right words to express themselves, and the words used are not appropriate.

This type of aphasia is usually found at a right hemiplegia (paralysis reaching the right half of the body), in which Broca's area is reached.

2.3. The mixed aphasia (conduction) [ 198 ]:

This type of aphasia is often found in a lesion that concerns the arcuate fasciculus [ 221 ] which links Wernicke's area to Broca's area.

Aphasia conduction is characterized by difficulties in expression and reception of speech. Support this type of aphasia is often very difficult, especially when the problems are important.