Disturbances of mental functions with local brain lesions, Speech...

Violations of mental functions with local brain damage

Speech disorders with local brain lesions

Aphasia is a speech disorder that occurs with local lesions of the cortex (and "the nearest subcortex") of the left hemisphere (in right-handed people) and is a systemic disorder of various forms of speech activity.

Aphasia should be distinguished from such speech disorders as:

• dysarthria - a violation of pronunciation without a disorder of listening, reading and writing;

• anomie - difficulty in naming stimuli of a certain modality;

• Alalia - Speech disorder in childhood due to underdevelopment of all forms of speech activity;

• motor speech disorders, associated with impaired subcortical motor mechanisms.

Sensory aphasia is a form of aphasia based on a disorder of phonemic hearing, i.e. ability to distinguish the sound composition of a word.

Violation of the phonemic hearing leads: - to disorganization of the entire speech system;

- the disappearance of the ability to distinguish the phonemes of the native language (with complete destruction);

- misunderstanding of fast or noisy speech, i.e. speech in complicated conditions (in less severe cases);

- defects in understanding of oral speech (central defect in this disease);

- the absence of active spontaneous oral speech;

- replacement of some sounds by others (literal paraphasia);

- replacing one word with another (verbal paraphasia) - occurs less often

- a sharp violation of the letter under dictation;

- difficulty in repeating the words you hear; read violation.

With acoustical-mnestic aphasia, the patient is not able to remember even relatively small speech material due to gross violation of the auditory memory.

With optic-mnestic aphasia, patients are not able to call objects.

With afferent motor aphasia, kinesthetic speech afferentation is violated, i.e. the possibility of the appearance of clear sensations coming from the articular apparatus into the cortex of the cerebral hemispheres during the speech act.

Semantic aphasia is expressed in a misunderstanding of grammatical constructions in patients; to a greater or lesser extent reflects simultaneous simultaneous analysis and synthesis of phenomena (when simultaneous representation of several phenomena is required).

Patients with aphasia do not understand a number of grammatical constructions that reflect spatial or "quasi-spatial" relationships, for example:

- Prepositions (do not see the difference in the expressions "circle above the cross", "circle under the cross"),

- words with suffixes

- comparative relationships (expressions like "Pen is longer than a pencil");

- the construction of the genitive case ("father's brother", "daughter's mother");

- Temporary constructions (such as "Before breakfast I washed my hands");

- spatial constructions (do not understand what is true: "Earth is illuminated by the sun" or "the sun is illuminated by the Earth");

- expressions containing logical inversions ("Kolya was struck by Petya. Who is the fighter?");

- expressions in which logically related words are far apart ("To the school where Petya studies, the poet came to read the poem");

- suggestions with rolling verbs.

With motor efferent aphasia, patients, trying to say something, say inarticulate sounds or one word with different intonations.

At the heart of dynamic aphasia are violations of the successive organization of speech utterance, i.e. patients find it difficult to give a detailed speech utterance. The speech of such patients is very poor, they do not speak out on their own, they answer questions in monosyllables, often repeating the words of the question in the answer.

A special place in neuropsychology is the problem of

pseudoaphasia, which is due to the fact that recently a very intensive study of deep brain structures began. Pseudo-facial speech defects can occur in tumors or vascular foci, located in the depths of the left hemisphere (its middle divisions), but not affecting the cortex of the cerebral hemispheres. In these cases, the phenomena of secondary dysfunction of the cortical structures of the brain entering the speech zone are possible. However, these speech disorders occur atypically, often in a mixed form.

A special type of speech disorders are the anomalies and of the dysgraphia that occur when the corpus callosum intersects due to a violation of interhemispheric interaction.

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