Aphasia Wernicke

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Aphasia Wernicke Broca

• Annabell Göbel Mareen Kalmes
• Katharina Kantz Daniel Lohner
• Manuel Brachtendorf Tim Held

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Overview

• 1. What is Aphasia?
• 2. Paul Broca
• 3. Brocas Aphasia
• 4. Carl Wernicke
• 5. Partner Work
• 6. Wernickes Aphasia
• 7. Treatment of Aphasia
• 8. Case Studies on Brocas Aphasia

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The use of speech to communicate is unique to
humans. When speech is impaired or absent, the
impact on the person and his family is profound
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• One of the most heartbreaking and devastating
  disabilities is aphasia. Most people have not
  heard about aphasia, nor do they know the term
  until someone in their family or a friend
  acquires aphasia. 1
• 1 NAA

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What is Aphasia?
Language disorder
resulting from
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damage to the brain

• caused by

• head traumas,
• brain tumors,
• brain infections,

• stroke

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http//www.hawdale-associates.co.uk/i/imgRightAndL
eftBrain.jpg
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Aphasia can affect

• production / comprehension of speech

• ability to read / write

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• expressive language (what is said)

• receptive language (what is understood)

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Varieties of Aphasia
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Broca's Aphasia
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Paul Broca

• many legacies which are important to medicine and
  psychology
• Localised speech function in Broca's Area

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Paul Broca

• "Tan" or "Tan-Tan" most popular case
• Tan could not produce a single word, only the
  syllable "Tan", due to a neurological problem
• Largely on the basis of Leborgne's case, Broca
  postulated that expressive language function was
  located in the posterior left frontal lobe
  ("Broca's Area").

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Photographs showing lateral views of the brains
of Leborgne (left) and Lelong (right). Broca
preserved the organs by immersing them in
alcohol he then donated them to the Musée
Dupuytren in Paris
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Broca's Area

• one of two speech centres
• located on the lateral surface of left hemisphere
  
• primarily involved in the production of speech
• part of the motor cortex
• controls muscels in the mouth
• coresponds to Brodman's area 44 and 45

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Broca's Aphasia

• Also known as expressive aphasia, agrammatic
  aphasia, motor aphasia, verbal aphasia
• The most common of the nonfluent aphasias
• Caused by damage to to the anterior region of the
  brain

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Broca's Aphasia

• Yes... ah... Monday... er... Dad and Peter H...
  (his own name), and Dad.... er... hospital... and
  ah... Wednesday... Wednesday, nine o'clock... and
  oh... Thursday... ten o'clock, ah doctors...
  two... an' doctors... and er... teeth... yah.

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Broca's Aphasia

• Sufferers often have problem of agrammatism
• Non-fluent
• Effortful speech output
• Telegraphic
• Simple phrases "Dog eat" rather than "The dog is
  eating"
• Utterances lack elaboration

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Broca's Aphasia

• Omit bound grammatical morphemes (morphology
  error)
• Omit function words (prepositions, articles) more
  likely than nouns ("walk dog")
• Tent to use nouns rather than verbs to describe
  actions
• Comprehend simple statements, but may not
  understand grammatically complex sentences

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Broca's Aphasia

• "cookie jar fall over chair water empty
  ov ov Examiner "overflow" Yeah.

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Broca's Aphasia

• some patients can count from one to ten, but
  cannot produce the same numbers in ordinary
  conversation
• Some patients may only be able to produce single
  word utterances
• May have difficulties finding the right word when
  speaking

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Broca's Aphasia

• Word substitution errors, usually meaning based
  (finger for toe)or sound based (mushroom for
  mustache)
• Movement errors (word and sound
  exchanges)e.g.1. "We'll sit around the song
  and sing fires" (fire and sing songs)

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Broca's Aphasia

• 2. "an anwage lacquisition device" ( a language
  acquisition device, "a" is replaced by "an"
• 3. "Even the best team losts" (Even the best
  teams lost)

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Broca's Aphasia

• Syntactic deficite.g. Word order problem1.
  "The boy kisses the girl" ? a reversible
  sentence, often misorder2. "The boy kicks the
  rock" ? real world knowledge, rock cannot kick a
  boy

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Broca's Aphasia

• Comprehension is usually preserved
• Patients are aware of language difficulties and
  may become frustrated and depressed
• Better recovery of language function than in any
  of the other aphasia syndromes

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Carl Wernicke

• German physician,
• anatomist, psychiatrist
• and neuropathologist
• 1848 in Tarnowitz, Poland
• 1905 in Gräfenroda, Germany

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• Paul Broca had published his findings on language
  deficits
• Wernicke began his own research into the effects
  of brain disease on speech and language
• He noticed that not all language deficits were
  the result of damage to Broca's area

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• 1874
• Der Aphasische Symptomencomplex
• 1881/83
• Lehrbuch der Gehirnkrankheiten

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• damage to the left posterior, superior part of
  the temporal lobe resulted in deficits in
  language comprehension
• Wernickes Area / Aphasia

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Wernicke's encephalopathy

• not related to damage of the speech and language
  interpretation area named after Wernicke
• syndrome characterized by loss of short-term
  memory
• result of inadequate intake or absorption of
  thiamine (Vitamin B1) coupled with continued
  carbohydrate ingestion
• most common cause of an onset is severe
  alcoholism, though there are several other causes
  
• may progress to coma or even death if untreated
• if treated early, recovery may be rapid and
  complete

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Wernicke-Korsakoff syndrome

• combined manifestation of two disorders
• - Korsakoff's Psychosis (confusion, amnesia)
• 
  
• - Wernicke's encephalopathy
• manifestation of Vitamin B1 deficiency, or
  beri-beri (in the US, this is usually secondary
  to alcohol abuse)

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Wernicke s Aphasia
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fluent aphasia

• connected speech with good intonation and
  pronunciation

but
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• Speech frequently includes errors

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Your Task

• Which kind of errors?

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Group 1

• You know that smoodle pinkered and that I want
  to get him round and take care of him like you
  want before."

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Group 2

• I felt worse because I can no longer keep in
  mind from the mind of the minds to keep me from
  mind and up to the ear which can be to find among
  ourselves.

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lexical errors

• irrelevant or nonsense words
• word substitutions

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syntactical errors

• sentence structures do not follow correct
  grammatical patterns

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utterances are

• incorrect
• and
• lack informative purpose

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Treatment of Aphasia

• Suspicion of aphasia -gt tests
• Speech-language pathologist -gt
• comprehensive examinations
• Sometimes recover without treatment ("spontaneous
  recovery)
• Most cases language recovery is not as quick

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• Recovery takes approx. 2 years
• Factors that influence the amount of improvement
  are
• the cause of the brain damage
• the area of the brain that was damaged
• the extent of the brain injury
• the age and health of the individual.

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• Aim to improve the patients ability to
  communicate by using the remaining abilities
• Individual vs. group treatment
• Individual treatment
• Focus on the specific needs
• Group treatment
• Use new communication skills within the group
  (role-play)

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Exercises

• To create situations of normal life
• To name objects, following directions, or
  answering questions
• Patients practice their use of communication
  skills in real life situations
• Last step Help to return to work or school

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Family members are encouraged to

• Simplify their language
• Repeat the content words or write down key words
• Include the person with aphasia in conversations
• Encourage any type of communication
• Help the individual become involved outside the
  home, e.g. stroke clubs