Clinical manifestations of dynamic aphasia
Dynamic aphasia is a pathological condition in which the ability of an active and expanded expression is disrupted. At the same time, it is difficult for a patient to construct an internal plan of his sentence. In specialists it has a second name - transcortical motor aphasia.
This kind of violation is difficult enough for analysis, as the patient retains the ability to read and write, there is no difficulty in repeating individual words and sentences, as well as in the names of objects.
This disorder, like dynamic aphasia, was discovered by the psychologist Kleist in the 1940s. He called the disease "loss of initiative."Any active utterance implies the ability of preliminary mental alignment. This is the kind of disorder that occurs when this type of disorder occurs.
Experts call this phenomenon a defect of predicativity. This is expressed in the change of the place of verbs in the sentence, the absence of intonational verbal coloring. For such a patient, it seems impossible to reproduce pronouns in other cases, except for the nominative. There is a lack of actualization of words.
Dynamic aphasia occurs when the posteroluminal parts of the first convolution of the left hemisphere of the cortex and the anterior parts of the speech zone are affected, namely, there is a block of activation and planning of speech activity. Most often, this kind of change occurs with ischemic changes in the brain that occur in the absence of normal blood flow in the basin of the left anterior cerebral artery.
Clinical picture of the disease
In severe cases, a patient with this form of aphasia responds to questions in monosyllables, his answer repeats the words of the question itself, and in the most severe cases he refuses to answer at all.
In addition, with this type of disease, minor disturbances of motor functions can be noted, in the total absence of paresis, facial expressions are impaired, the emotional side is somewhat inhibited, the movements are somehow constrained and slowed down. Critical state in relation to himself at the same time completely preserved, there are attempts to participate in the conversation with other people.
The picture of speech disturbance in them is as follows:
- Difficulties at actualization of some words, especially it concerns to verbs.
- A person with dynamic aphasia seems to be very difficult to complete a task for verbal associations and the specialist can easily identify a sharp decline in the patient's vocabulary.
- When constructing written phrases, as with many other variants of aphasia, there is a lack or excess of the construction of sentences and a change in the orderliness of words.
The manifestation of aggra- matism is expressed in the omission of a number of words( predicate, pronoun, noun or excessive use of the subject, as well as introductory words).There are a lot of template phrases, the sentences are very concise.
Dynamic aphasia is one of the most complex disorders, and all complex mechanisms of the origin of this phenomenon continue to be studied by scientists around the world.
Detection of dynamic aphasia
Scheme for determining the type of aphasia is as follows:
- Conducting a conversation to explore common communicative abilities. At the same time, the possibilities of completeness of the patient's speech utterance, his activity, and his perception of situational and everyday speech are determined.
- Identify understanding of the interlocutor's address. For this it is suggested to retell an uncomplicated text, to repeat simple and more complex sentences spoken aloud. The patient may be offered to find some items, explain the meaning of some sayings.
- Expressive speech is examined by request to repeat sounds, words and phrases of varying degrees of complexity, designate the definition and word of the image in the pictures, of any action performed. The doctor also asks the patient to make a written or oral description of the plots on the proposed images.
- The study is also subject to the possibility of reading, writing and counting.
Treatment and therapy
As with other types of speech disorders, the earlier the beginning of studies with such a patient, the more favorable the forecast. It is also important that there is help and support from surrounding people, as the patient remains critical of his illness.
The result also depends on the prevalence of the lesion and the possibility of restoring the functional structures of the brain.
Recovery for dynamic aphasia is as follows:
- The patient should draw up a story plan for a specific set of special images of one storyline.
- Drawing up a plan file.
- Providing the patient with a certain dictionary, composed by transitional phrases( "when", "sometimes", "once").