aphasia
Introduction
Introduction to aphasia Aphasia refers to the pathological changes of brain tissue related to language function, such as stroke, brain trauma, brain tumor, brain inflammation, etc., causing damage to human understanding and expression ability of communicative symbol system, especially speech and vocabulary. , grammatical and other components, language structure and language understanding and expression of language barriers, as well as the decline of language cognitive processes and functional impairment. Aphasia does not include linguistic symptoms caused by disturbance of consciousness and general mental retardation, nor does it include audible, visual, writing, pronunciation, and other sensations of language and reading, and writing disorders. Some patients show better understanding of certain semantic categories of vocabulary, while others have poorer understanding of vocabulary, such as letters, numbers, colors, and body part names can be selectively damaged. It is usually a localized damage to the linguistic area around the lateral hemisphere. Semantic connection and partial retention of semantic knowledge. Clinically, although patients cannot accurately understand the meaning of words, they can attribute the word to a certain category and have semantic connections. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: affective mood disorder memory impairment
Cause
Cause of aphasia
Stroke (45%)
The main manifestation is that the expression disorder is obvious to the mental disorder and the prognosis is better. 1. Injury localization: the dorsal posterior part of the superior hemisphere (the cortex from the anterior superior frontal lobes to the anterior parietal region, including the insular lobes and the superior sylvian cortex).
Nervous system lesions (20%)
Due to the extensive hemispherical motor and the extensive pathological changes in the sensory area or the disruption of the contact pathway caused by the subcortical lesions, the Marie quadrilateral region is damaged, and the nerves in this region are damaged, conduction is blocked, and aphasia is caused.
Tumor (5%)
The lesion involves a unilateral or bilateral temporal lobe.
Prevention
Aphasia prevention
There are no effective preventive measures for this disease. Early detection, early diagnosis and early treatment are the key to the prevention and treatment of this disease. Once the disease occurs, it should be actively treated to prevent the occurrence of complications. In daily life, we should pay attention to safety, especially to protect the brain from trauma, in order to prevent traumatic injury to the corresponding parts of the brain, leading to aphasia; at the same time, we should also pay attention to the development of daily diet, psychology and living habits, avoid cardiovascular disease, so as not to induce A moderate stroke, which leads to aphasia.
Complication
Aphasia complications Complications, affective mood disorder, memory impairment
Intelligent changes occur, such as memory, logical thinking, calculations, and changes in attention.
Symptom
Aphasia symptoms common symptoms, pronunciation disorder, learning disabilities, memory impairment
Hearing disorder
It is generally believed that the process of speech-understanding is the reception of acoustic speech signals, the vocal meaning of sound units, that is, the perception of phonemes, the recognition of phoneme sequences with specific meanings, that is, the understanding of vocabulary and semantics, and the semantics that produce multi-level meaning. The complex interaction of units, that is, the understanding of syntax.
The listening and comprehension disorder of aphasia can manifest as obstacles in one or more of the above-mentioned obstacles, thus showing different listening and comprehension disorders.
1. Pure words: Wernicke believes that the back of the scorpion (Wernicke area) is the storage warehouse of the auditory vocabulary image, and its damage often causes the perceptual difficulty of the auditory language, that is, complete or partial vocabulary. Patients with pure vocabulary understand or retell the verbal stimuli presented by the auditory sense, while reading, reading, writing, and spontaneous speaking are relatively normal. They can hear and understand non-verbal stimuli such as car horns, rain, dog barking and other environmental sounds. Really pure words are rare, and most patients show other characteristics of mild aphasia, such as occasional phonemic idioms, and mild naming difficulties.
2. Selective damage in the semantic category: Some patients show better understanding of certain semantic categories of vocabulary, while others have poorer understanding of vocabulary, such as letters, numbers, colors, and body parts. Damage. It is usually a localized damage to the linguistic area around the lateral hemisphere.
3. Semantic connection and partial retention of semantic knowledge. In clinical practice, although patients cannot accurately understand the meaning of words, they can attribute the word to a certain category and have a semantic connection.
4. Short-term memory impairment: The understanding of vocabulary and sentences requires a short storage of the received speech sequence in memory. Patients do not have much difficulty understanding simple sentences with only one meaning link, but they encounter difficulties in understanding information consisting of several meaningful links or complex grammatical structures. Due to the destruction of short-term memory, mutual interference occurs between several meanings of information, and the suppression of patients can well remember a meaning center (information block), but cannot reproduce other meaning centers.
5. Syntactic comprehension damage: Some patients with aphasia can understand the meaning of words, especially nouns. They can understand single words and similar meanings. They can understand simple sentences, but they cannot understand complex grammatical structures.
Speech expression disorder
1. Speech abusiveness: refers to the inability to convert a formed and filled speech frame into a purposeful speech campaign plan due to brain damage. The speech exercise plan specifies the moving target of the vocal organ (such as the round lip and the tip of the tongue). The basic unit of the exercise plan is the phoneme, and each phoneme series has its space and time assignment.
2. Grammatical deficiencies: In non-fluent aphasia patients, they often see that their speech expressions are mostly real words, but lack of grammatical function words, relatively few verbs, and speech can not be expanded, that is, "telegraph type" speech.
3. Retelling Difficulties: The simplest form of expressive speech is retelling speech. The simple retelling of phonemes, syllables, and words requires precise hearing, and the phoneme is analyzed. Finally, the memory synthesis of the retelling material is formed and becomes retelling. Another condition is to have a fairly accurate pronunciation system, as well as a conversion from one pronunciation unit to another, or one word to another.
4. Naming errors: Patients with various types of aphasia are naming errors when naming. Common name errors include slang, semantic idioms, phonetic idioms, irrelevant utterances, new words, negative reactions, and so on.
Examine
Aphasia check
Language function evaluation
The evaluation of language function applies a complete evaluation of individuals with aphasia, usually a measure of severity, which can be used to classify aphasia in an individual. This standardized aphasia assessment included: Boston Diagnostic Aphasia Check, Minnesota Aphasia Differential Diagnosis Test. Western aphasia test and aphasia screening test, Frenchay aphasia screening test. There are also commonly used Chinese aphasia tests in China.
1. Boston Diagnostic Aphasia Check (BDAE). Standard aphasia check that is commonly used in English-speaking countries. It consists of 27 subtests and is divided into 5 major projects. (1) conversation and self-expression speech; (2) listening comprehension; (3) oral expression; (4) written language comprehension; (5) writing.
2. The Western Aphasia Test (NAB), which evolved from BDAE, allows differential diagnosis of aphasia and severity.
3. Chinese Standard Aphasia Check: In 1997, the China Rehabilitation Research Center was composed of 30 subtests and was divided into 9 large projects. Only suitable for adults with aphasia.
4. Chinese Aphasia Grand Test: Prepared by the Neuropsychological Research Office of the First Hospital of Beijing Medical University. Started in 1986 for treatment.
Functional communication ability evaluation
In the process of interpersonal communication, both verbal and non-verbal communication content plays a big role. The functional evaluation focuses on whether the subject can communicate normally, not his defects.
Common ones are:
1. Daily life interaction activity check (CADL).
2. Functional Evaluation of the Communication Ability of the American Speech and Hearing Association (ASHA-FACS).
3. Functional Communication Test (FCP).
Diagnosis
Diagnosis of aphasia
It can be diagnosed from the patient's expression, communication problems, family descriptions, and examination results.
Aphasia severity graded aphasia severity grade--Boston Aphasia Diagnostic Test (BDAE):
Level 0: Lack of meaningful speech or listening comprehension.
Level 1: There are discontinuous verbal expressions in verbal communication, but most require the listener to speculate, ask, and guess; the range of information that can be exchanged is limited, and the listener finds difficulty in verbal communication.
Level 2: With the help of the listener, it is possible to communicate with familiar topics, but often it is impossible to express their own thoughts on strange topics, making it difficult for patients and assessors to communicate with each other.
Level 3: With little or no help, patients can discuss almost all of their daily problems, but some conversations are difficult or unlikely due to weak speech or comprehension.
Level 4: Fluent in speech, but observing obstacles to understanding, there is no obvious limit on the expression of thought and speech.
Level 5: There are very few speech barriers that can be distinguished. Subjects may feel somewhat difficult subjectively, but the listener may not be clearly aware of it.
