Difference between revisions of "Broca's aphasia"

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<embedvideo service="youtube" Alignment="right">https://youtu.be/6e7oZqyEtNQ</embedvideo>When unilateral
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<embedvideo service="youtube" Alignment="right">https://www.youtube.com/watch?v=RMa9BVpJkYQ</embedvideo>Aphasia is an acquired disorder of language, including various combinations of impairment in the ability to produce, understand and repeat speech, as well as defects in the ability to read and write.(1-3) Using bedside testing, the aphasias have been classified in several ways. A commonly used scheme includes Broca's, Wernicke's, conduction, global, transcortical (motor, sensory and mixed) and anomic. A key distinguishing feature is fluency. Nonfluent speech is laborious, with single words, short phrases, pauses and hesitation. In severe aphasia, the patient may be unable to utter a single word or endlessly repeat a monophasia. Aphasia is a disorder of language, as opposed to dysarthria, which is a disorder involving the mechanics of speech production.
  
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Broca’s aphasia (expressive, motor or anterior) aphasia is a nonfluent type of aphasia due to a -lesion involving the anterior perisylvian speech areas in the posterior inferior frontal region. Patients have labored, uninflected, nonfluent spontaneous speech with a decreased amount of linguistic output: few words, short ¬sentences, and poor grammar. In severe Broca’s aphasia, the speech consists of nouns and substantive verbs produced with great effort. There is a tendency to leave out nonessential words such as adjectives, adverbs, and functor words (telegraphic speech). Speech comprehension is relatively unimpaired.
  
 
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The patient in the video suffered a large hemorrhagic stroke involving the left hemisphere and has been left with a right spastic hemiplegia and Broca's aphasia. He is severely nonfluent with very sparse, effortful and largely unintelligible verbal output. Comprehension is well preserved; he follows simple commands and clearly understands what is said to him. He can recite overlearned material, the days of the week, but can't spontaneously give the correct day. He has a repetitive utterance, or monophasia, something to the effect of "I bad." He is very aware of and frustrated by his speech limitations..  
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<embedvideo service="youtube" Alignment="right">https://youtu.be/6e7oZqyEtNQ</embedvideo>When unilateral pharyngeal weakness is present, the midline raphe of the palate will deviate away from the weak side and toward the normal side on phonation or when eliciting the gag reflex.(1,2) This movement is usually dramatic. Minor movements of the uvula and trivial deviations of the midline raphe are not of clinical significance. Unilateral palatal weakness occurs most often in lateral medullary syndrome. Involvement of cranial nerves IX and X by a process involving the lower cranial nerves, e.g., the jugular foramen syndrome, is a less frequent etiology.
 
 
 
This patient had a partial lateral medullary syndrome due to a vertebral artery dissection that caused right palatal weakness and facial sensory loss.
 
  
 
==References==
 
==References==
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1. Campbell WW. DeJong's the neurologic examination, 7th ed. Philadelphia: Wolters Kluwer
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Health/Lippincott Williams & Wilkins, 2013.
  
1. Campbell WW. DeJong's the neurologic examination, 7th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013.
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2. Campbell WW. Clinical signs in neurology: a compendium. Philadelphia: Wolters Kluwer Health, 2016.
  
2. Campbell WW. Clinical signs in neurology : a compendium. Philadelphia: Wolters Kluwer Health, 2016.
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3. Alexander MP, Hillis AE. Aphasia. Handb Clin Neurol. 2008;88:287-309.
  
 
[[Category:Cranial Nerve Signs]]
 
[[Category:Cranial Nerve Signs]]

Revision as of 19:12, 24 September 2017

Aphasia is an acquired disorder of language, including various combinations of impairment in the ability to produce, understand and repeat speech, as well as defects in the ability to read and write.(1-3) Using bedside testing, the aphasias have been classified in several ways. A commonly used scheme includes Broca's, Wernicke's, conduction, global, transcortical (motor, sensory and mixed) and anomic. A key distinguishing feature is fluency. Nonfluent speech is laborious, with single words, short phrases, pauses and hesitation. In severe aphasia, the patient may be unable to utter a single word or endlessly repeat a monophasia. Aphasia is a disorder of language, as opposed to dysarthria, which is a disorder involving the mechanics of speech production.

Broca’s aphasia (expressive, motor or anterior) aphasia is a nonfluent type of aphasia due to a -lesion involving the anterior perisylvian speech areas in the posterior inferior frontal region. Patients have labored, uninflected, nonfluent spontaneous speech with a decreased amount of linguistic output: few words, short ¬sentences, and poor grammar. In severe Broca’s aphasia, the speech consists of nouns and substantive verbs produced with great effort. There is a tendency to leave out nonessential words such as adjectives, adverbs, and functor words (telegraphic speech). Speech comprehension is relatively unimpaired.

The patient in the video suffered a large hemorrhagic stroke involving the left hemisphere and has been left with a right spastic hemiplegia and Broca's aphasia. He is severely nonfluent with very sparse, effortful and largely unintelligible verbal output. Comprehension is well preserved; he follows simple commands and clearly understands what is said to him. He can recite overlearned material, the days of the week, but can't spontaneously give the correct day. He has a repetitive utterance, or monophasia, something to the effect of "I bad." He is very aware of and frustrated by his speech limitations..

References

1. Campbell WW. DeJong's the neurologic examination, 7th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013.

2. Campbell WW. Clinical signs in neurology: a compendium. Philadelphia: Wolters Kluwer Health, 2016.

3. Alexander MP, Hillis AE. Aphasia. Handb Clin Neurol. 2008;88:287-309.