Language disorders

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Language disorders

• Based on
• Investigation of neurological patients (SOTE,
  1999)
• Szirmai Neurológia (Hungarian textbook,
  Medicina, 2002)
• Goetz and Pappert Textbook of clinical neurology
  (Saunders, 1999)

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Language an elementary model

• auditory analysis
• sounds
• auditory lexicon
• spoken words

picture analysis letters written
lexicon written words
Sentence composition
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Speech vs. language

• Speech audible and articulate form of human
  expression produced by the action of the vocal
  cords and muscles of the tongue, pharynx, soft
  palate and face.
• Language the faculty of expressing thoughts or
  feelings by spoken words, writing or gestures and
  the reception and interpretation of those.

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Speech language disorders

• Dysphonia problem of producing sounds
• Dysarthria problem of forming sounds
  (articulation)
• Aphasia disorders of language caused by
  circumscript cerebral lesions

Muscles work abnormally Only the motor aspect of
language is involved.
Brain (usually cortex) works abnormally Receptive
and/or executive functions of language lost
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Language subtypes

• Propositional (symbolic) ideas
• Emotional affective content

Left hemisphere Right hemisphere
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Languageanatomy
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Compre-hension (spoken language)
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Reading 1.
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Reading 2.

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Aphasia clinical examination

• Spontaneous speech (How did you get to the
  hospital?)
• Comprehension - simple commands
• - complex tasks (semantics)
• Repetition (simple and complex)
• Naming
• Reading
• Writing

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Motor (Broca) aphasia

• non-fluent, strained speech
• agrammatisms (lack of prepositions, auxilaries
  etc.) -gt telegram speech
• comprehension good
• repetition poor (except for elementary words)
• naming difficult but easier than spontaneous
  speech
• agraphia possible (Exners area)
• emotional speech intact
• patient is conscious of own condition -gt may be
  depressed
• other symptoms hemiparesis with faciobrachial
  dominance, spasticity, no sensory or visual loss

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Sensory (Wernicke) aphasia

• fluent speech with normal prosody but
  unintelligible for others and patient
• reduced content, many expletives
• jargon aphasia (neologisms and paraphasias)
• comprehension bad
• repetition poor (except for elementary words)
• naming bad
• agraphia may be present or writing meaningless
• patient is NOT conscious of own condition -gt NOT
  depressed
• other symptoms right hemisensory loss, right
  homonymous hemianopia, mild degree of paresis

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Conduction aphasia

• nearly fluent speech with normal prosody
• severe word-finding difficulty with paraphasia
  and logoclonia
• comprehension good
• repetition poor
• naming bad
• reading aloud is impaired but not silent reading
• other symptoms right hemisensory loss, right
  homonymous lower quadrant anopia, mild degree of
  paresis

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isolational
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Subcortical aphasia
transcortical aphasia paraphasia bad
comprehension fluent speech paraphasia
errors in spontaneous speech naming difficulty
forgetting of words difficulty of phrase
formation (connections with limbic sy. /
memory) fluent aphasia neologisms semantic
paraphasia
Thalamus DM nucl. L medial nucl. L
caudate putamen Basal ganglia
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Alexias
anterior central posterior (associative)
splenium c. callosi