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APHASIA : EXPLAINED + MCQ

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If one can not comprehend or produce spoken or wri en language inspite of having normal
vision/hearing/ motor function then he/she is said to be aphasic.
CONCEPT OF CEREBRAL DOMINANCE : it says that aphasia is due to aection of dominant /
categorical hemisphere.

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FIGURE 1; IT WILL EXPLAIN HOW SPEECH IS PRODUCED???

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Generally we divide aphasia into uent , non uent and anomic aphasia. there are other types also as
condoction aphasia.
FIRST WE TAKE UP ANOMIC APHASIA: Note that in damage to angular gyrus only naming is
aected as there is problem in understanding wri en language or picture especially NAMING ,
otherwise comprehension of wri en or spoken language is intact. SEE FIGURE BELOW

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NOW SEE DAIGRAM OF WERNICKES APHASIA

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Q1. ALL ARE TRUE ABOUT WERNICKES APHASIA EXCEPT..

A] SPEECH IS FLUENT AND GRAMMATICALY CORRECT
B]SPEECH IS INCOMPREHENSIBLE DUE TO NEOLOGISM
C] READING AND WRITING IS ALSO IMPAIRED
D] LESION IS SEEN IN POSTERIOR PERISYLVIAN REGION
E] MOST COMMON CAUSE IS EMBOLISM IN DOMINANT SUPERIOR DIVISION OF MIDDLE
CEREBRAL ARTERY.
ANS : E] most common cause of wernickes aphasia is embolism in INFERIOR DIVISION OF MCA
which supplies are no 22 present in posterior perisylvian region.
NOW SEE THE FIGURE BELOW TO UNDERSTAND BROCAS APHASIA:

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Q2] ALL ARE TRUE ABOUT BROCAS APHASIA EXCEPT
A]SPEECH IS NON FLUENT AND INTERUPTED BY MANY WORD FINDING PAUSES
B]NAMING & REPETATION IS IMPAIRED
C]NO IMPAIREMENT IN WRITING
D]COMPREHENSION OF WRITTEN AND SPOKEN LANGUAGE IS INTACT

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E]PATIENT IS UNAWARE OF THE DEFICIT

F] LESION INVOLVES INFERIOR FRONTAL GYRUS SUPPLIED BY SUPERIOR DIVISION OF
MCA
ANS [C] & [E]
AS most of the patient show severe writing impairement{ check out comments below this topic to know
why writing is impaired} & patient is aware of his decit .
CONDUCTION APHASIA: Speech output is uent but paraphasic ie cant put parts of word together
. Repeatation , naming , writing is impaired but comprehension of spoken language is intact. Earlier
it was thought to be due to lesion in arcuate fasciculus but now it is considerd to be due to lesion in
auditory cortex ( area 40,41,42).
NOTE [1] PURE WORD DEAFNESS= IMPAIREMENT OF COMPREHENSION FOR SPOKEN
LANGUAGE ONLY.
[2] PURE ALEXIA =COMPREHENSION IS IMPAIRED ONLY FOR WRITTEN LANGUAGE
REFERENCE 1. GANONG PG 297, 23RD ED [2] HARRISONS MANUAL OF MEDICINE 18ED PAGE
335
Posted by Dr Sujeet Kumar on April 12, 2013 in NEUROLOGY.
3 Comments

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3 Responses
drkushal447 says:
April 12, 2013 at 7:25 am (Edit)
i have a question.
Why is writing impaired in lesion of brocas area?

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Reply
Dr Sujeet Kumar says:
April 12, 2013 at 10:15 am (Edit)
WRITING IS IMPAIRED IN MOST CASES[ Hson manual of medicine 18ed page 336]. Writing is
assessed for spelling errors , word order , grammer[ hson 17ed pg 163].Brocas area is concerned
with maintaining word order and grammer of language ie spoken and wri en. comprehension is
preserved in brocas aphasia except for grammer part so brocas aphasia is not purely expressive
aphasia as it has agrammatism [hson pg 164 17ed]
While none of the books i reered for this topic mentions it clearly , why writing is impaired ?
,but above lines makes us to draw inference that due to improper word order and grammatical
errors writing is impaired.HOPE U GOT UR ANSWER.
Reply
drkushal447 says:
April 13, 2013 at 2:45 pm (Edit)
thanks will denitely read up the source you quoted but your reasoning seems to be bang
on thanks!

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