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Aphasia PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Aphasia” by Kenneth M. Heilman MD.

This medical PowerPoint presentation is about aphasia, a language disorder that affects a persons ability to communicate. It is usually caused by damage to the parts of the brain that are responsible for language processing, such as the left hemisphere of the brain. People with aphasia may have difficulty with speaking, understanding, reading, and/or writing. The severity and type of language difficulties experienced can vary depending on the location and extent of the brain damage.

Different types of aphasia include Brocas aphasia, Wernickes aphasia and Global aphasia.

Tags : Aphasia, language disorder, Brocas aphasia, Wernickes aphasia, Global aphasia, Neurology, Neurology PowerPoint presentation

Published on : Jun 07, 2023 | Views : 1522 | Downloads : 1

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Slide 1-

Aphasia Kenneth M. Heilman MD Distinguished Professor Emeritus and Staff Neurologist, VAMC
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Testing for Aphasia:1) Spontaneous Speech a) fluency; b) phonemic paraphasic errors; c) semantic paraphasic errors; d) absence of function words. 2) Repetition(“No if ands or buts.”)3) Comprehension (lexical and grammatical) 4) Naming
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Gall’s Hypotheses: 1) Modularity 2) Magnitude3) Skull Size and Shape 4) Ernest Aubertin (1825–1893) 5) Broca’s patient Leborgne also called “tan.” Leborgne
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Broca’s Aphasia Non fluent, impaired repetition, impaired naming, agrammatism (expression and comprehension) and relatively intact comprehension.
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Nonfluent/agrammatic variant primary progressive aphasia Agrammatism in language production, effortful, halting speech with inconsistent speech sound errors (apraxia of speech), agrammatism, spared single-word comprehension Predominant left posterior fronto-insular atrophy
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Lesion of Broca Area
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Wernicke’s AphasiaLogorrhea, with neologisms, phonemic and semantic paraphasic errors; impaired repetition, naming and comprehension.
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Geschwind and Levitsky 1968Measured from the primary auditory cortex to the end of the Sylvian fissure or Wernicke’s area. Found that it was larger in left than right hemisphere, providing support of Gall’s postulate. M. LeMay 1976with right handed healthy participants, the left occipital pole, protrudes more posteriorly. Gall was correct! .
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Conduction AphasiaFluent speech with phonemic paraphasic errors and attempted corrections; impaired repetition and naming, relatively intact comprehension.
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Wernicke’s Model
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WERNICKE’S MODEL STROKE APHASIC SYNDROMES A: Pure word deafness: Impaired comprehension of speech or repeat, normal spontaneous speech, and naming. B: Wernicke’s aphasia: Impaired comprehension of speech, naming and repeating. Fluent with neologisms, phonemic, semantic errors. C: Conduction aphasia: Intact comprehension, impaired repetition and naming, fluent with phonemic errors. D: Broca’s aphasia: Non-fluent, impaired naming, impaired repetition, intact comprehension
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Lichtheim’s Aphasias 1885E. Transcortical Sensory Aphasia: Impaired comprehension, normal repetition, normal naming and spontaneous speech.F. Transcortical Motor Aphasia: Non-fluent speech, with intact naming, repetition and comprehension.G. Mixed Transcortical Aphasia: Non-fluent, impaired comprehension, impaired naming, repetition intact. y :
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Lichtheim Model Wernicke’s phonological-lexicon Sematic Network Auditory cortex Broca’s area Motor cortex B A C D E G F
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Anomic Aphasia: Cannot be explained by Lichtheim model.Lichtheim = It does not exist, but it does. y :
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SEMANTIC NETWORK PHONLOGICAL LEXICON WERNICKE’S AREA AUDITORY ANALYSIS PRIMARY AUDITORY CORTEX PHONETIC PROCESSOR BROCA’S AREA MOTOR CORTEX SPEECH INPUT A C D B E SPEECH OUTPUT F G H A
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Revised Lichtheim ModelA = Pure word deafnessB =Wenicke’s aphasiaC = Conduction aphasiaD = Broca’s aphasiaE= AphemiaF&H or G = Transcortical Sensory AphasiaH=Anomic aphasiaF= Transcortical aphasia with intact namingPROBLEMS: Can not explain 1) deep aphasia; 2) optic aphasia; 3) non-optic aphasia
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N
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Modified Wernicke-Kussmaul-Lichtheim schema language disorders.Stroke and focal injury: Locus of dysfunction and aphasia type:a = pure word deafnessb = wernicke’s aphasiac = deep dysphasia d = conduction aphasiae = broca’s aphasiaF = aphemiaG = transcortical sensory aphasia with intact spontaneous speechH & J = transcortical sensory aphasiaI = anomic aphasiaJ = optic aphasia K = associative agnosiam = apperceptive agnosia L
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N
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PRIMARY PROGRESSIVE APHASIA-NEURO-DEGENERATIVE DISEASESD = Logopenic primary progressive aphasia-Alzheimer’s diseasee = Non-fluent primary progressive aphasia-Picks, Frontotemporal dementia H = semantic dementia-frontotemporal demential&H =Mixed transcortical aphasia –Pathology not knownB&H =Non-optic aphasia-Pathology not known
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treatments:1) Underlying disease2) speech therapy3) medications: a) empirical findings describing beneficial effects of pharmacotherapy on language disorders remain limited B) Catecholamines: most widely investigated class of drugs so far has been the catecholamines such as Bromocriptine, Levodopa, Dextroamphetamine, and Amantadine:, Administration of dopamine agonists to such patients has been found to enhance speech initiation, reduce pauses and paraphasias in conversations, increase naming accuracy, improve repetition abilities, promote verbal (phonological) fluency, and shorten verbal latencies;, but success is variable.
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c) cholinergic and glutamatergic: donepezil and Memantine. In several studies, cholinergic or gluatamtergic-based interventions have, indeed, been found to improve performance on naming and comprehension tasks among aphasic patients with posterior lesions and patients with fluent aphasia 4) BRAIN STIMULATION A) Direct Current Stimulation: the literature suggests combining therapy with anodal (excitatory) stimulation to the left hemisphere and/or cathodal (inhibitory) stimulation to the right hemisphere can increase both naming accuracy and speed when compared to the effects of therapy alone. B) inhibitory low-frequency TMS to the right inferior frontal gyrus enhanced language recovery, as measured by aphasia severity, expressive language, and receptive language