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PubMed1992

[Activation of deficient right cerebral blood flow by language after global aphasia].

A 39-year old patient abruptly presented with global aphasia. Six years later a mild deficit of articulation and sentence comprehension persisted. A cerebral blood flow study showed that a) during verbal activations, the blood flow increased in the right hemisphere and decreased around the lesion in the left hemisphere; b) the activation was globally higher than in the control group. These data suggest that the right hemisphere plays a significant role in the recovery from aphasia in patients with severe left hemispheric lesions.

Adult↗
PubMedDate not supplied

[Aphasia and parietal syndrome as the presenting symptoms of a demyelinating disease with pseudotumoral lesions].

INTRODUCTION: Multiple sclerosis (MS) often presents with sensory symptoms, which are usually due to spinothalamic or spinal cord disorders; parietal syndrome is, however, very rare as the initial symptom. Likewise, aphasia is also an infrequent symptom of MS; in the few cases that have been reported, it is usually linked to the existence of important pseudotumoral lesions. CASE REPORT: We describe the case of a 31-year-old female with a 48-hour history of a progressive clinical picture consisting in nominal aphasia and a sensory parietal syndrome. Magnetic resonance imaging showed a lesion 3.6 cm in diameter that was hyperintense in T2 with perilesional edema and minimal gadolinium uptake, along with other images that revealed increased signal intensity in the periventricular subcortical white matter on the right-hand side and in the left-hand frontal subcortical region. A spectroscopic analysis of the largest lesion revealed that this lesion showed evidence of inflammation, with cell destruction and replacement, although it was not possible to distinguish between a demyelinating disease and a high grade glioma. Hence, a brain biopsy was required in order to reach the final diagnosis of demyelinating pseudotumoral lesion. CONCLUSIONS: Giant pseudotumoral plaques are a rare form of presenting symptom in MS; use of the clinical features, simple images and spectroscopy is not a very reliable means of reaching a differential diagnosis with a tumour and this often makes it necessary to conduct a biopsy study of the lesion.

Adult↗
PubMedDate not supplied

Primary progressive aphasia as the initial manifestation of corticobasal degeneration. A "three in one " syndrome?

In 1994, the term "Pick complex" was proposed to indicate significant clinical and pathological overlapping between primary progressive aphasia, frontal lobe dementia and corticobasal degeneration. We report the case of a 60-year-old man, who initially presented progressive non-fluent aphasia with orofacial apraxia, and subsequently, over a period of 3 years, developed mutism, pathological laughter, extrapyramidal rigidity, dystonia, alien hand syndrome and bulbar signs. An extensive haematological, immunological and biochemical work up was normal. The results of neuroimaging studies and neuropsychological tests, along with the clinical evolution, finally led us to the ?three in one? diagnosis, supporting the concept of Pick complex.

Aphasia, Primary Progressive↗
PubMed1990

[Speech therapy for Aphasia following cerebrovascular accident].

Cerebrovascular accidents of the dominant hemisphere often result in aphasia. In this article the different types of aphasia are briefly explained and the pattern of spontaneous recovery, as well as the determining factors for the evolution, are discussed. Some therapeutic approaches are outlined and the main studies investigating the efficacy and specificity of speech therapy are presented. Finally, criteria for the selection of patients for intensive speech therapy are suggested.

Aphasia↗
PubMed1990

[Epilepsy-acquired aphasia syndrome with psychosis. Report of a case ].

We report the case of a boy whose development was normal until the age of three when regression with loss of speech occurred. Other anomalies included eating and sleep disorders, sterotyped behavior disorders, suggesting infantile psychosis. The electroencephalogram evidenced paroxysmal anomalies, particularly during sleep, with no clinical seizures. The diagnosis of epilepsia-acquired aphasia syndrome (Landau-Kleffner syndrome) was made. The psychotic disorders were not considered as a differential diagnosis but rather as intertwined with the elements of the syndrome. The relationship between acquired aphasia and psychosis are discussed.

Aphasia↗
PubMed2006

[A case of amyotrophic lateral sclerosis presenting as motor aphasia in its early stage].

A 76-year-old right-handed woman complained of speech disturbance and difficulity of singing was admitted to our hospital. Examination showed motor aphasia and mild cognitive impairment. After she was discharged, dementia and weakness of the extremities had rapidly progressed. She was readmitted eight month after the first visit, when she was almost abulic, her skeletal and bulbar muscles were remarkably atrophic, and hyperreflexia of the extremities were seen. Electromyographcal study showed neurogenic pattern. These findings suggest amyotrophic lateral sclerosis (ALS) with dementia. Pathological findings were atrophy at the anterior horn of the spinal cord. The brain was diffusely atrophic. The extent of degenerative change was not lateralized. This case is a discriminative type of ALS with dementia, that its first symptom is motor aphasia.

Aged↗
PubMed2006

[Primary progressive non-fluente aphasia].

When a subject shows changes in his/her ability to express himself/herself verbally or to understand the messages from the people he/she relates with, it is customary to say that such a person has a language disorder, nosologically classified in the field of aphasias. In this article, we show the case of a patient diagnosed with progressive aphasia, where such a diagnosis describes the data resulting from the neuropsychological assessment process. Finally, we provide a few reflections with regard to the case.

Aged↗
PubMed1991

[Psychometric speech studies in Alzheimer's dementia with the Aachen aphasia test].

Dementias of the Alzheimer type seem to be frequently accompanied by language disturbances. These may represent a feature which can be of help in distinguishing them from other types of dementias. We used the Aachen aphasia test in 32 patients suffering from Alzheimer dementia according to research criteria, and a mixed sample of 35 patients suffering from other dementias. From these 2 groups 2 subsamples of 21 patients each were gathered which were comparable with regard to age, disease onset, level of education, verbal intelligence and severity of senility. Nevertheless it was possible to distinguish the groups to a certain degree on grounds of psychometric language criteria alone. Alzheimer patients were more severely handicapped communicatively, less dysarthric, produced more automatisms and discretely more phonemic paraphasias with fluent speech which was sometimes paragrammatic. A relatively better level of repetition compared to the Token test and written language was fairly specific. A computer-assisted classification yielded language disturbances similar to Wernicke's aphasia more often than with non-Alzheimer dementias. We found no Alzheimer patients with a Broca's type of language disorder, while amnestic and global types were bound to the level of overall impairment to a certain degree. The significance of these results with regard to the use of psychometric language test in the dementias, particularly Alzheimer's dementia, and to differential diagnostic considerations are reviewed briefly.

Aged↗
PubMed2006

[Design and implementation of aphasia rehabilitation software based on speech recognition].

A new software therapy instrument is proposed for the rehabilitation of aphasia caused by cerebral disorder, which is different from general drug therapy or physical therapy and is, based on modern speech and biofeedback principles. Aphasia rehabilitation software package on the therapy instrument were designed and implement. The features of the software and its future application were discussed.

Aphasia↗
PubMed1991

[Lipomatous hypertrophy of the interauricular septum as a cause of cerebral embolism in a patient with isolated Wernicke's aphasia].

The clinical observation of a 74 year old male presenting isolated Wernicke's aphasia due to a temporal left infarction of cardiac embolic origin secondary to paroxysmal auricular flutter is described. Transthoracic and transesophageal echocardiography, computerized tomography and magnetic resonance provided characteristic images which permitted the establishment of the diagnosis of lipomatous hypertrophy of the interauricular septum without requiring the use of invasive techniques. Lipomatous hypertrophy of the interauricular septum is a cardiac tumor of unusual presentation constituted of an abnormal accumulation of non-encapsulated fatty tissue which occupies a thickness greater than 15 mm of the interauricular septum. Wernicke's aphasia as a form of presentation of the lipomatous hypertrophy of the interauricular septum has not previously been described in the literature.

Aged↗
PubMed1991

[Slowly progressive aphasia without dementia].

Slowly progressive aphasia without dementia is a rare disease, first described in 1982. Since then the existence of a nosological entity bearing that name is disputed. Case histories of two patients are described, with emphasis on clinical presentation and the importance of early diagnosis and neuropsychological evaluation. It is concluded that slowly progressive aphasia is a sign caused by a neurodegenerative cerebral disorder starting in the dominant hemisphere, ultimately accompanied by symptoms of generalised dementia.

Aged↗
PubMedDate not supplied

[Initial experiences in the combined treatment of aphasia patients following cerebrovascular insult by speech therapists and music therapists].

With the publication we try to indicate the common work of speech therapist and music-therapist of the medical treatment of aphasic patients after a cerebrovascular accident (stroke). This combined method of medical treatment has been proved best. In the geriatric centre in Berlin-Buch the co-operation is carried out in the following way: the logopaedic diagnosis of the kind of aphasia is so that the speech therapist and music-therapist can start treating the patients suffering from aphasia with special modified therapy programmes which is coordinated with each other. Most patients can be treated with logopaedic methods successfully. Patients who are difficult to treat with logopaedic methods get additional music therapeutic treatment so that the whole success of medical treatment becomes more comprehensive and more effective.

Aged↗
PubMed1987

An innovative therapeutic program for aphasia patients and their relatives.

Eleven aphasia patients and seven family members participated in a five-day residential course led by a speech pathologist, a psychologist and a neurologist. The aim of the course was to give the aphasics and their relatives information on the etiology, treatment possibilities and prognosis of aphasia; work on personal and interpersonal problems through psychological counseling; improve language function through comprehensive and intensive stimulation; examine the psychological, linguistic and neurological effects of the intensive course. The course participants met again one year after the course and were found to have changed positively both psychologically and interpersonally but, as expected, only to a minor degree linguistically and neurologically. Through this intensive course it was possible to assess the problems of the families more easily than in the hospital. The patients and their relatives reported that they had learnt how to identify and to deal with their psychological problems in a more constructive way. They also felt that they had support from the other families and were able to share their experiences. We found that this type of intervention had many positive effects on the ability of the participants to cope with the chronic disability.

Adaptation, Psychological↗
PubMedDate not supplied

[Catamnestic studies of patients with aphasia after stroke].

In 28 patients with aphasia after stroke speech ability was studied twice at intervals of 1-4 years. A comparison of the initial results with those after follow-up showed that the process of return of speech ability (especially in case of motor aphasia) is not limited to the early post-stroke period of several weeks to several months, but takes a much longer time. This justifies logopedic treatment of aphatic patients (also in sanatorium) even many months after stroke.

Adult↗
PubMed1988

[Rehabilitation prognosis of aphasias of various etiologies with reference to clinical, neurolinguistic and computerized tomography findings].

To obtain further insights into the rehabilitation outlook in different baseline conditions, a comparison was made of data and treatment outcomes in 92 patients having aphasias of different etiology and disease duration. Rating as "improved" was contingent on significant changes in at least 2 subtests of the AAT (Aachener Aphasietest), which is a fairly stringent requirement. This criterion was met by some 35% of the patients overall, independent of their age; the percentage increased to 45% in case of treatment onset during the first year, while in later onset, significant improvement was achieved in 15% only. Aphasic syndromes secondary to hemorrhage, trauma, tumors, or infections, usually are less severe than the predominant classical syndromes, i.e. Global, Broca and Wernicke aphasia, caused by ischemic stroke. CT lesion size did not yield any definite information. Minor improvements below the required significance levels, and, above all, gains in communication performance, i.e. further consolidation, could be achieved by appropriate management even after the crucial initial year, which, however, does not imply any fundamental changes in the rehabilitation prognosis as such.

Aphasia↗
PubMedDate not supplied

[Logopedic considerations in the diagnosis and therapy of aphasia patients following stroke].

It was observed that one-third of all patients suffer from aphasic disturbances following cerebrovascular insult. Therefore, there is a need for special logopedic diagnostics and treatment in the framework of the complex rehabilitation program. From a practical point of view, the following diagnostic and/or therapeutic methods have proved successful: --the Aachen aphasia test; --stimulation treatment, circuitous methods, and compensatory techniques. It was proven that by a special logopedic therapy an obvious improvement of the different aphasia forms has been achieved.

Aged↗
PubMed1989

[Acquired childhood aphasia and epilepsy].

The article described one of three cases of a rare syndrome of acquired infantile acute epileptic aphasia. The course of clinical, pedagogical and electroencephalographical signs were analyzed. Besides a severe speech defect caused by sensomotor aphasia, the female patient had generalized tonic-clonic convulsions. EEG featured the changes typical of the Lennox-Gastaud syndrome. The steady nature of the defect was apparently related to the spread of paroxysmal activity over both hemispheres with preponderant involvement of the left temporal region.

Aphasia↗