In Wernicke's aphasia, the key deficit is comprehension, whereas, with dementia, the problem is with memory. In both cases, patients may have trouble answering basic orientation questions. Wernicke's aphasia must be distinguished from Alzheimer Dementia. Neuroimaging (CT, MRI, fMRI, PET, or SPECT) may be required to localized and diagnose the etiology of the aphasia. When testing comprehension, it is advisable to start with simple commands such as "close your eyes" or "open your mouth." Then, administer more complex commands, "show me two fingers on your left hand" and commands that require crossing the midline such as "touch your right ear with your left hand." The Boston Diagnostic Aphasia Examination is a widely used test to evaluate patients with language deficits. Formal neuropsychiatric testing may be necessary to determine the type and degree of the language deficit. On the bedside examination, each component of language should be tested including assessments of verbal fluency, ability to name objects, repeating simple phrases, comprehension of simple and complex commands, reading, and writing. Recovery also depends on area and size of damage, patient age and status of the contralateral cortex. If there is involvement of the middle/inferior temporal gyri or the inferior parietal lobule, recovery is unlikely. Wernicke aphasia usually involves the posterior one third of the superior temporal gyrus. Sometimes, the patient may become aware of the errors in language if it is presented to them in an audio format. In general, patients with wernicke aphasia are not aware of their deficits in the long run they do become frustrated that others are not able to understand what they are saying. An early clue to Wernicke aphasia is the abnormal spelling. even when they are able to write fluently, the choice of words and spelling is abnormal. In some cases, there is impairment in reading. Repetition and naming items isusually abnormal. They also do not display the same degree of emotional outbursts and depression seen with Broca's aphasia. As opposed to Broca's aphasia, patients with Wernicke's aphasia often do not have hemiparesis accompanying the language deficit. Unlike Broca's aphasia, patients with Wernicke's aphasia speak with normal fluency and prosody and follow grammatical rules with normal sentence structure. Associated neurological symptoms depend on the size and location of the lesion and include visual field deficits, trouble with the calculation (acalculia), and writing (agraphia). As with Broca's aphasia, repetition is also impaired. Reading involves the comprehension of written words, and thus reading is also often impaired in Wernicke's aphasia. Because of these deficits, patients may find it easier to substitute a generic word such as "thing" or "stuff" instead of saying the word they wish to say. An example of a semantic paraphasia error would be a patient saying "watch" instead of "clock." An example of a phonemic paraphasic error would be a patient saying "dock" instead of "clock." In severe cases, these errors can result in neologisms (new words) or word salad which makes communication nearly unintelligible. Paraphasic errors come in two forms: semantic paraphasia errors where one word is substituted for another and phenomic paraphrastic errors where one sound or syllable is substituted for another. However, the content is often difficult to understand because of paraphrastic errors. In Wernicke's aphasia language output is fluent with a normal rate and intonation.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |