Aphasia - impaired speech in local brain lesions.

Aphasia manifests itself in lesions of the left hemisphere (temporal, parietal regions) in right-handers.

Aphasia is a speech disorder that occurs when the left hemisphere is affected in right-handers and is a systemic disorder of various forms of speech activity. Elementary forms of auditory sensitivity are not violated.

Classification of aphasia by Luria.

Speech includes expressive speech, impressive speech, reading, writing. All this is a speech activity.

1 type of aphasia - Wernicke's sensory aphasia. Occurs when the Wernicke zone is affected - in the posterior third (22 nd field) of the superior temporal gyrus.

Violation of phonemic hearing. That is, the ability to distinguish one sound from another by ear. Violation of the ability to distinguish the sound composition of the word. In rude cases, expressive and impressive speech is disturbed. Primary defect - speech understanding is impaired. The patient can not understand what sound is pronounced. Sound discrimination - as a link of control suffers.

Speech sick verbal salad. In less severe cases, there are substitutions for similar ones. Patients pronounce similar words, but with the replacement of sounds. The replacement of sounds or letters is literal paraphasia. According to the principle of similarity of sound bp, in-f. Reading aloud and dictation letters is broken. With gross violations, the patient may not understand what we are saying to him. He will hear a set of sounds. The survey is carried out according to written instructions. In less severe cases, we will test the phonemic hearing. For this you need to quickly speak the instructions. From the patient will be asked to repeat the words, sounds.

With fast reading, the number of literary paraphasias will increase many times. Samples are conducted with increased interference, complicated - sensitized.

In sensory aphasia, the patient is very sociable, talkative. It is necessary to slow down the wrong speech of the patient. From understanding individual words to understanding individual sounds.

2 type of aphasia - acoustic-mnestic . Occurs with the defeat of 21 and 32 fields, 2 temporal gyrus. The central factor is a violation of hearing-speech memory. The patient correctly understands speech. The patient can not keep in memory even a small auditory speech material. When talking, the phenomenon of reminiscence is observed. Patient delayed reproduces the material better than directly. In rough cases, the patient can not even keep a few sounds in memory. In less severe cases, the patient will understand individual words, but just add new information, the old one is immediately forgotten, and the new one is remembered.

Interference - the replacement of old information with new information is a hindrance, the phenomenon in which new memorable elements interfere with the reproduction of other elements. In such patients, retroactive inhibition is also observed. At the heart of any interference is inhibition. As well as proactive braking - the previous group does not remember the subsequent information. Speech in such patients will be changed. It will be scanty, often with the omission of nouns, and the substitution of words - verbal paraphasia can also be observed. (pen on pencil, ax on hammer ...)

The letter, reading is in principle intact. A letter is not from memory.

When acoustical-mnestic aphasia from understanding the entire text, to memorizing the meaning of individual phrases and sense-of-speech memory.

3 types of aphasia - afferent motor aphasia. It occurs with the defeat of 40 fields. Lower postcentral departments. Violation of afferent kinesthetic link.

Violation of thin articulation movements. In rough cases, the patient cannot utter a separate sound. 1-2 words can be saved - emboli. These are the words that are most often pronounced before the disease. in less severe cases, automated forms will be more secure. These are the names of loved ones, poems, interjections. The patient will speak incomprehensibly due to the replacement of the article number. The same verbal, literal aphasia - D, L, N - not by the similarity of phonemes, but by the principle of the similarity of articulation. Oral praxis is disturbed in a patient (cannot touch the tongue, inflate the right cheek ...). The patient hears his mistake, but the mouth does not obey. The patient may withdraw. For rehabilitation training - you need to slow down the speech. The letter suffers - literal aphasia by the similarity of articulation. Suffering from reading the similarity article.

4 types of aphasia - efferent motor aphasia - 44 field of the left hemisphere. Lower premotor parts are responsible for the kinetic factor. He will be broken. In case of violation of the kinetic factor, a violation of the denervation (inhibition) of the previous element and the innervation of the subsequent element occur. Reminds perseveratsii - the elementary jam on operation. Systemic perseverations are also possible - sticking on the action.

In rough cases, the patient will not be able to say at all. Separate inarticulate sounds. Emboli may persist - verbal stereotypes. He gets stuck and replaces the rest of the words.

In less severe cases, the patient can pronounce words with the same syllables. The grammatical system is disturbed - such a style of speech arises - called the telegraph style. The whole statement is replaced by individual words. Verb Loss. A second letter is broken, reading, even if not apraxia.

5 type of aphasia - optical-mnestic aphasia. Temporal-occipital parts of the left hemisphere are involved. Violations - the destruction of the connection between the word and the image. Nomination function violated. There will be a long word search. Mild speech disorders. There may be a phenomenon of alienation of the meaning of the word. Some familiar word is perceived as foreign (for which there is nothing).

6 type of aphasia - dynamic aphasia - 9, 10, 46 fields - the defeat of the premotor areas, which are adjacent from the front to the top of the Broca area. Central factor - factor regulation. The patient's speech is disturbed with the help of which we build statements, we coordinate speech. The main mechanism is a violation of the construction of a holistic statement. Violation of active productive speech.

The appearance of a defect: the lack of speech initiatives. The patient has no spontaneous independent speech. The patient speaks when asked about something. The answer will be monosyllabic, in a brief passive form. Often there are echolalia - that is, the repetition of the last word that the patient hears. The patient will not be able to write an essay. Speech stamps may persist. The detection method is an experiment of given associations: the patient will call 2-3 words and calm down. For example, you need to name a few pieces of furniture.

The predicativeness of speech in the inner plane is violated. Expressive speech suffers.

7 type of aphasia - semantic aphasia - occurs when TPO zone is violated, 37, 39 field.

The main defect - a violation of "associative" factors - provides simultaneous analysis and synthesis. The main defect is a violation of the spatial factor in speech, spatial and quasi-spatial relations in speech. The manifestation of aphasia - the patient looks pretty intact. Simple sentences The patient understands and speaks in simple sentences. If the grammatically construction reflects spatial or quasi-spatial relations, then the patient will not understand and will not be able to say anything. The real space around the patient can be described with pretexts: in, behind, above, below ... Quasi-space is how we agreed on a piece of paper: up, down, left, right. Or an ashtray - a thing filled with something. Or the earth is illuminated by the sun, etc. It is difficult to understand sentences with logical connections, a violation of simultaneous synthesis, and reading comprehension is disturbed. A letter - as a mechanical act is not violated, and the understanding of what is written - is not available.