Global aphasia

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Global aphasia is a type of aphasia that is commonly associated with a large lesion in the perisylvian area of the frontal, temporal and parietal lobes of the brain causing an almost total reduction of all aspects of spoken and written language.[1] It involves a "left side blowout" which includes Broca's area, Wernicke's area and the Arcuate fasciculus. It can also be seen in the initial stages of large left middle cerebral artery injuries that may progressively improve to become expressive aphasia.[2]

Global aphasia has been cited as among the most common type of aphasia in patients referred for speech rehabilitation therapy.[3][4]

Presentation

The presentation of global aphasia are those of severe expressive aphasia and receptive aphasia combined. There is absence or severe impairment of both comprehension and expression of language. Persons with global aphasia are often mute or reduced to a few stereotyped words or sounds.[1] Other cognitive skills remain functioning - a phenomenon affirming that language faculty is indeed a separate domain. [citation needed] Patients with global aphasia are not impaired in reorientation tasks, either, confirming their ability to integrate spatial cues even in the absence of verbal assistance. [5]

Prognosis

Persons with a large injury to the left perisylvian areas of the brain, often initially show signs of global aphasia in the first 1–2 days due to brain swelling (cerebral edema). With some recovery, impairment presentation may progress into expressive aphasia (most commonly) or receptive aphasia.[2][3] Improvement may occur in one or both areas (expressive and receptive language) over time. However, studies show that spontaneous improvement, if it happens, occurs within six months, but complete recovery is rare.[4]

References

  1. 1.0 1.1 Rothstein, Jules M. (2005). The Rehabilitation Specialist's Handbook. Philadelphia: F.A. Davis Company. pp. 372–373. ISBN 0-8036-1238-9. 
  2. 2.0 2.1 Blumenfeld, M.D., Ph.D, Hal (2010). Neuroanatomy through Clinical Cases, Second Edition. Sunderland, Massachusetts: Sinauer Associates, Inc. pp. 434–437. ISBN 978-0-87893-058-6. 
  3. 3.0 3.1 Sarno, MT (1970). "A survey of 100 aphasic Medicare patients in a speech pathology program". J Am Geriatr Soc 18: 471. doi:10.1016/0093-934X(81)90124-3. Retrieved 12 May 2011. 
  4. 4.0 4.1 Prins, R; et al. (1978). "Recovery from aphasia: Spontaneous speech versus language comprehension". Brain Lang 6: 192. doi:10.1016/0093-934X(78)90058-5. Retrieved 12 May 2011. 
  5. Bek, Judith; Blades, Mark (2010). "Language and Spatial Reorientation: Evidence From Severe Aphasia". Journal of Experimental Psychology 36 (3). 


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