NIMHANS 2018-GUIDANCE SERIES-  APHASIAS

WERNICKE's APHASIA[AIIMS MAY-1998***]

*    Here comprehension is  impaired.

 *Fluency is preserved.

*It is also called as Jargon Aphasia and is associated with Neologisms.

* Repetition,   Naming,   reading,   writing is also impaired.

*The common cause is and emboli to Inferior Division of MCA.

*This involves the wernickes area in the posterior.  1/3 of superoir. Temporal sulcus. (sensory speech area).

*Intracerebral hemorrhage,   severe head trauma,   or neoplasm are other causes. Insight is typically  lost*

BROCA'S APHASIA[AI-2007***]

*    In this condition comprehension is preserved.

*Fluency is decreased.

*It is called as ‘Bound morpheme’- agrammatism.

*Speech is telegraphic  but  informative.

*Insight  is preserved*.

*The common cause is infarction in Broca’s area and is  due to occlusion of the superior division of the middle cerebral artery,  which involves posterior part of Inferior Frontal Gyrus

CONDUCTION APHASIA

*    It is due to functional disconnection between Brocas,   wernicke area.

* Speech is Fluent but paraphasic.

* Comprehension is intact.

*Reading aloud is impaired but reading comprehension is preserved.

ANOMIC APHASIA [AIIMS MAY-1999***]

*    Articulation,   comprehension,   repetition are  intact.

* Confrontation naming,   word finding and spelling  are  impaired.  The speech is fluent but uninformative.

*The site of lesion is  the  left hemisphere language network.

*It is the commonest language disturbance following head injury,   metabolic encephalopathy and  Alzheimer. **

GLOBAL APHASIA

*    The speech output is nonfluent,   and comprehension of spoken language is severely impaired.

* Naming,   repetition,   reading,   and writing are also impaired.

*It is due to a combined dysfunction of Broca's and Wernicke's areas and results from strokes that involve the entire middle cerebral artery distribution in the left hemisphere.

* It is associated with  right hemiplegia,   hemisensory loss,   and homonymous hemianopia. 

NON FLUENT TRANS CORTICAL APHASIA (Transcortical Motor Aphasia)

*    The features are similar to Broca's aphasia,   but repetition is intact and agrammatism may be less severe.

*The lesion site  involves the anterior watershed zone between anterior and middle cerebral artery territories or the supplementary motor cortex in the territory of the anterior cerebral artery.

Fluent Transcortical Aphasia (Transcortical Sensory Aphasia)

*    It is similar to those of Wernicke's aphasia,   but repetition is intact.

*    There is  disconnection of the intact core of the language network from other temporoparietal association areas.

*Associated neurologic findings may include hemianopia.

*Cerebrovascular lesions (infarctions in the posterior watershed zone) or neoplasms that involve the temporoparietal cortex posterior to Wernicke's area are the most common causes.