Neurological conditions are not the only health conditions in the world, but as according to an article by "THE NEUROLOGICAL ALLIANCE" published in 2019, there are 14.7 million neurological cases in the world, which leads to equates to a 1 in 6 persons having a neurological condition. Today, I will be discussing about one of the conditions, and this condition has to do with a person's inability to talk or disruption in the ability to talk. Today, I will discussing on the neurological condition called Aphasia.
Aphasia is cognitive disorder which causes a reduction, or disruption in the ability to speak as well as loss of language ability. This is usually as a result of a damage in the area of the brain responsible for speech or language, or the surrounding areas of the brain region responsible for speech. The areas of the brain responsible are the Broca, arcuate fasciculus, and Wernicke areas. This could be as a result of trauma or injury to the brain areas, cerebrovascular accident (CVA) such as strokes, presence of brain mass, inflammation of the brain cells (encephalitis) and neuro-degenerative diseases.
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There are 180,000 new cases of Aphasia in the United States of America annually, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). The language areas of the brain are located in the dominant hemisphere, and 90 - 95% of people with Aphasia have injuries in the dominant left hemisphere, and the major causes of aphasia are cerebrovascular accidents such as stroke, which ocurs as a result of the inability for blood to reach the brain, or it could occur as a result of damage done to the subsortical structure of the left hemisphere in the brain. Aphasia is common among the elderly.
The language area of the brain is determined by the dominant hand of the patient. If the patients are right handed individual, they very often going to have their language area in the left hemisphere of the brain, and can also exist in the right hemisphere, like in the case of about 70% of left handed individuals, while in few cases, both hemispheres can support language. It is important to know that the Broca, and Wernicke areas are important areas of language in the brain. The language centers are in located in the frontal lobe and the temporal lobe, with the Broca's area at the frontal lobe, and the Wernicke's area in the temporal lobe. The broca's area is in the posterior-inferior frontal lobe of the brain, responsible for speech formation and spoken language, and speech, while the Wernicke's Area is in the Posterior-Superior Temporal Lobe of the brain. It is responsible for speech organization. The Arcuate Fasciculus connects the Broca's area and the Wernicke's area together.
Aphasia can be Fluent Aphasia, and Non-fluent Aphasia with several groups within them. Non-fluent aphasia is known as Broca's Aphasia, or expressive aphasia, which is as a result of lesion or impaired broca's area, while Fluent Aphasia is known as Wernicke's aphasia due to lesion or impaired wernicke's area. A combination of Wernicke's and Broca's aphasia is known as Global aphasia. With Global Aphasia, the lesion is large thereby affecting both the Broca's area, and the Wernicke's area. Other groups of Aphasia within the major types are Conduction aphasia where the lesion is located in the arcuate fasciculus, the area between the Broca's area and the Wernicke's area. Another group of Aphasia is the Transcortical Aphasia, which can be divided into the Transcortical Sensory Aphasia, and the Transcortical Motor Aphasia. With Transcortical Motor Aphasia, the lesions are around the Wernicke's area and not in the area itself while Transcortical Motor Aphasia has to do with lesions around the Broca's area but not in the Broca's area itself. There are cases of Mixed transcortical aphasia which has to do with lesions around both the Broca's area, and the Wernicke's area. Another type of Aphasia in the group is the Anomic Aphasia, which is when lesions occur at the angular gyrus.
With Non-fluent Aphasia, the patient has intact comprehension, but unable to communicate spontaneously. Repetition is a serious issue as they cannot speak fluently. With non-fluent aphasia, paraphasia isn't common.
With Fluent Aphasia, patients are able to have good spontaneous speech, but with poor comprehension with spoken and written words. Patients with fluent aphasia usually make up new words, and do not often know when they make these mistakes.
Moving on to Global Aphasia, patients usually have poor spontaneous speech, language comprehension, poor ability to repeat words and continually create new words without knowing they are doing so.
Transcortical Sensory Aphasia patients have fluent speech, they are able to repeat words, but they have impaired comprehension.
Transcortical Motor Aphasia patients have non-fluent speech, but the have intact comprehension, and are able to repeat words or sentences.
Patients with Mixed Transcortical Aphasia are non-fluent with words, having poor or impaired comprehension, but they are able to repeat words and sentence.
Conduction Aphasia patients are able to have spontaneous speech, they have good comprehension of words but have difficulty in repeating words, they would also have phonemic paraphasias but they are able to identify their mistakes and do well to correct them.
Patients with Anomic Aphasia are fluent with words thereby allowing them to have good spontaneous speech, intact comprehension, and be able to repeat but will not be able to have proper word reasoning (Word Blindness).
Treatments for aphasia depends on the underlying cause of the aphasia, the age, the patients handedness, and so on. It is important to treat the underlying problem causing the aphasia in other to get the patient to regain full level of independence speech, comprehension, and fluency.
https://www.neural.org.uk/assets/pdfs/neuro-numbers-2019.pdf
https://www.nidcd.nih.gov/health/aphasia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2557073/
https://www.ncbi.nlm.nih.gov/books/NBK559315/
https://www.sciencedirect.com/topics/neuroscience/aphasia
https://www.statpearls.com/ArticleLibrary/viewarticle/43129
https://www.nhs.uk/conditions/aphasia/
https://www.hopkinsmedicine.org/health/conditions-and-diseases/aphasia