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Receptive Aphasia

Aphasia Fluent

Receptive, or Wernicke's aphasia, is distinguished by the inability to understand words or auditory signals, most commonly caused by cerebrovascular disorders, tumors or central nervous system infections. The diagnosis is made through a detailed patient interview and imaging studies.


Presentation

Aphasia is most frequently encountered in middle-aged individuals and the elderly, as the most common causes are cerebrovascular insults and degenerative diseases (dementia), while central nervous system infections and neoplasms are other notable causes [1]. The clinical presentation of patients with receptive (also known as fluent aphasia) is centered around the inability to comprehend words or any kind of auditory signal [2]. This condition is also known as Wernicke's aphasia, named after Carl Wernicke who was the first person to recognize this disease. In this condition, both visual and tactile symbols may not be recognized [3]. The term "fluent" aphasia describes the fluent and adequate speech seen in these patients, but with an uncharacteristic incorrect use of words in a nonsensical (known as paraphasia) or repetitive pattern [1] [2] [4]. It must be noted that patients are often unaware of the fact that their speech is without meaning [3]. Moreover, inability to recall names of objects that are used on an everyday basis (anomia), as well as alexia and agraphia, defined as impaired ability to read and write words, respectively, are frequently encountered in patients suffering from receptive aphasia [2] [3]. In some cases, visual deficits (primarily the right visual field) may be encountered due to the proximity of the left temporoparietal area to the visual pathway [3].

Schizophasia
  • See also Aphasia Expressive aphasia Schizophasia Conduction aphasia Logorrhea Agraphia Paragrammatism Transcortical sensory aphasia References Wernicke's APHASIA.[research.omicsgroup.org]
  • Mixed transcortical aphasia Progressive Aphasias Progressive nonfluent aphasia Semantic dementia Logopenic progressive aphasia Speech disturbances Speech disorder Developmental verbal dyspraxia /‎ Apraxia of speech Auditory verbal agnosia Dysarthria Schizophasia[en.wikipedia.org]
Urinary Retention
  • Acute use of an indwelling catheter may facilitate fluid management, prevent urinary retention, and reduce skin breakdown in patients with stroke.[doi.org]
Dysmetria
  • […] ophthalmoplegia One and a half syndrome Midbrain (CN 3, 4) Weber's syndrome ventral peduncle, PCA Benedikt syndrome ventral tegmentum, PCA Parinaud's syndrome dorsal, tumor Nothnagel's syndrome Claude's syndrome Other Alternating hemiplegia Cerebellum lateral ( Dysmetria[research.omicsgroup.org]
Dystonia
  • […] syndrome ventral tegmentum, PCA Parinaud's syndrome dorsal, tumor Nothnagel's syndrome Claude's syndrome Other Alternating hemiplegia Cerebellum lateral ( Dysmetria Dysdiadochokinesia Intention tremor ) medial ( Cerebellar ataxia ) Basal ganglia Chorea Dystonia[research.omicsgroup.org]
Focal Seizure
  • Focal seizures presenting as episodic receptive aphasia can be the only symptom of this infection. Being able to recognize these episodes as focal seizures, determining the cause, and timely treatment can decrease mortality/morbidity.[neurology.org]
Myelopathy
  • External links Aphasia Center of California in Oakland, CA, U.S. v t e Lesions of spinal cord and brain Spinal cord / vascular myelopathy sensory: Sensory ataxia Tabes dorsalis motor: Motor neurone disease mixed: Brown-Séquard syndrome cord syndrome ([research.omicsgroup.org]
  • Retrieved from v t e Lesions of spinal cord and brain Spinal cord / vascular myelopathy sensory: Sensory ataxia Tabes dorsalis motor: Motor neuron disease mixed: Brown-Séquard syndrome cord syndrome ( Posterior Anterior Central / Syringomyelia ) Subacute[en.wikipedia.org]

Workup

The diagnosis of receptive aphasia can be made through a simple verbal interaction with the patient (if he/she is conscious, as cerebrovascular insults can render patients unavailable for communication) [3]. Bedside testing to detect specific subtypes of aphasia and exclude other conditions that share a similar clinical presentation, for eg. severe dysarthria, psychosis, delirium, and other acute psychiatric conditions, hearing loss, but also a foreign language background, is the mainstay during workup [1]. Evaluation of spontaneous speech, writing and reading, naming of different objects, comprehension of spoken language, and word repetition may provide sufficient clues to confirm the diagnosis [1] [3]. Cognitive testing may be a useful tool, while imaging studies - magnetic resonance imaging (MRI), magnetic resonance angiography, and even computed tomography (CT) can be of extreme importance in identifying the lesion responsible for the onset of symptoms, such as neoplastic tumors, abscesses or hemorrhage [3] [4] [5]. In virtually all patients, posterior superior and middle temporal gyri will be the site of damage [4].

Epileptiform Activity
  • The clinical course of our patient with transient EEG and PET findings suggest that glucose metabolism in LKS cannot be attributed solely to interictal epileptiform activities on scalp EEG.[ncbi.nlm.nih.gov]

Treatment

  • Silkes J (2018) Masked Repetition Priming Treatment for Anomia, Journal of Speech, Language, and Hearing Research, 61 :3, (690-712), Online publication date: 15-Mar-2018.[doi.org]
  • […] and duration of treatment for each individual patient.[en.wikipedia.org]
  • Both participants demonstrated improvement in some aspects of discourse production associated with the confrontation naming SFA treatment.[ncbi.nlm.nih.gov]
  • There are many types of treatment available and the type of treatment depends on the needs and goals of the person with aphasia.[diseaseinfosearch.org]
  • Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only.[drugs.com]

Prognosis

  • Research is not suggesting the only way therapy should be administered, but gives insight on how therapy affects the patient's prognosis.[en.wikipedia.org]
  • The treatment and prognosis of these latter conditions differ from stroke, and thus SPECT plays a role in patient management.[ncbi.nlm.nih.gov]
  • Receptive aphasia is initially difficult to treat and less experienced stroke-clinicians on the multidisciplinary team might believe that the prognosis of speech recovery is limited.[ausmed.com]
  • Prognosis The outcome of aphasia is difficult to predict given the wide range of variability of the condition. Generally, people who are younger or have less extensive brain damage fare better.[brainfoundation.org.au]

Etiology

  • It can be said, however, that speech delay is a common childhood problem that affects 3 to 10 percent of children. 4 – 6 The disorder is three to four times more common in boys than in girls. 5, 7 Etiology Speech delay may be a manifestation of numerous[aafp.org]
  • Further tests are done to determine the etiology of the lesion (eg, stroke evaluation ) as indicated.[msdmanuals.com]
  • Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'.[icd10data.com]

Epidemiology

  • Epidemiology The aetiology is damage or disease of the brain and so it is most common in old people. Disease is usually vascular, neoplastic or degenerative.[aacknowledge.org.uk]
  • As a general rule, a lesion of the left hemisphere will cause dysphasia whilst, in the right hemisphere, it will cause neglect, visuo-spatial and cognitive problems. [ 2 ] Epidemiology The aetiology is damage or disease of the brain and so it is most[patient.info]
  • […] strangers 3 to 4 years Three to six words per sentence; asks questions, converses, relates experiences, tells stories; almost all speech understood by strangers 4 to 5 years Six to eight words per sentence; names four colors; counts 10 pennies correctly Epidemiology[aafp.org]
Sex distribution
Age distribution

Pathophysiology

  • Stroke: Pathophysiology, Diagnosis, and Management . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 58. Kirschner HS. Aphasia and aphasic syndromes. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds.[medlineplus.gov]

Prevention

  • Since stroke is a common cause of aphasia, follow these guidelines to help prevent stroke: Exercise regularly.[winchesterhospital.org]
  • Prevention Knowing your stroke risk factors, following your doctor's recommendations and adopting a healthy lifestyle are the best steps you can take to prevent a stroke.[mayoclinic.org]
  • The highest priorities of early stroke rehabilitation are to prevent recurrence of stroke, manage comorbidities, and prevent complications (Evidence Level C).[doi.org]
  • The professional roles and activities in speech-language pathology include clinical/educational services (diagnosis, assessment, planning, and treatment); prevention and advocacy; and education, administration, and research.[asha.org]
  • […] an Audiologist: Risks of Otitis Ask an Audiologist Hi, I was diagnosed with serious otitis from a walk-in clinic with a prescription of Advil and… September 12th, 2018 by hearingsolutions General 5 Signs of Noise-Induced Hearing Loss and How You Can Prevent[hearingsolutions.ca]

References

Article

  1. Schoeman R, Van der Merwe G. Aphasia, an acquired language disorder. SA Fam Pract. 2010;52(4):308-311.
  2. Baker JC, LeBlanc LA, Raetz PB. A Behavioral Conceptualization of Aphasia. Anal Verbal Behav. 2008;24(1):147-158.
  3. Porter RS, Kaplan JL. Merck Manual of Diagnosis and Therapy. 19th Edition. Merck Sharp & Dohme Corp. Whitehouse Station, N.J; 2011.
  4. Schwartz MF, Kimberg DY, Walker GM, et al. Anterior temporal involvement in semantic word retrieval: voxel-based lesion-symptom mapping evidence from aphasia. Brain. 2009;132(12):3411-3427.
  5. Moreaud O, David D, Brutti-Mairesse MP, Debray M, Mémin A. Aphasia in elderly patients [Article in French]. Psychol Neuropsychiatr Vieil. 2010;8(1):43-51.

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Last updated: 2019-07-11 21:32