What are the speech symptoms of aphasia?

Listening comprehension disorder is a common symptom of aphasia patients, which refers to the decrease or loss of patients' ability to understand spoken language. According to the type and degree of aphasia, they have different levels of understanding obstacles in words, short sentences and articles.

(1) speech recognition disorder

Patients can hear the sound like ordinary people, but when listening to the other person, they can't recognize the sound they hear, giving people a feeling that they can't hear it. Patients may say that they don't understand each other or keep asking each other to repeat or ask questions. After pure tone hearing test, the hearing is normal or only the high-frequency hearing outside the voice frequency is weakened. The typical case is pure word deafness, which is an occasional acceptance disorder in clinic.

(2) Obstacles in semantic understanding

This situation is the most common in aphasia. Patients can correctly recognize the pronunciation, but there are repeated and continuous sound and meaning interruptions, so that they can't partially or completely understand the meaning of words. Common in the following situations: serious people can't understand the names or simple greetings of common items in daily life; At the middle level, patients have no difficulty in understanding common nouns, uncommon words or nouns but verbs; When the sentence is long and the content and structure are complex, mild patients often cannot fully understand it.

2. Oral expression disorder

(1) Pronunciation difficulties

The dysarthria of aphasia is different from that of speech-related peripheral neuromuscular structures, and pronunciation errors are often changeable. Because of speech apraxia, most of these mistakes can only be found in serious cases. In a moderate situation, we can see the separation of casual speech and intentional expression, that is, the intentional expression language is obviously not as good as casual speech, imitation language is not as good as spontaneous language, and pronunciation errors are often inconsistent, including prosodic disorders and four-tone errors.

(2) Try to speak

Generally speaking, it is often related to dysphonia, which is characterized by poor language when speaking, and patients are often accompanied by sighing facial expressions and body postures.

(3) typo

There are three common misspellings, namely phonetic misspelling and new word misspelling. Phonetic misspelling is a substitution between phonemes. For example, the semantic spelling of "banana" is "fragrant cat", which is the substitution between words. For example, "desk" as a new word for "chair" is a meaningless word or a newly coined word, not a word that can't be said, such as "pencil" as "grinding small".

(4) Random words

Also known as strange words, when expressed, a large number of typos are mixed with new words, lacking substantive words, and even the words spoken are difficult for the other party to understand.

(5) Difficulties in finding words and naming.

It refers to the difficulty or inability of patients to say proper words in conversation, which is more common in nouns, verbs and adjectives. Because of the difficulty in finding words, they often pause, even silence, or display repeated ending words, prepositions or other functional words. All patients have different degrees of difficulty in finding words. If the patient can't find the right words to express himself, this is called circuitous phenomenon. When facing an object or a picture, it is called a curse obstacle.

(6) Rigid language

Common in critically ill patients, it can be rigid monosyllabic words, such as "click", "click", "eight" and "mom" and "person". It is limited to patients with rigid language, that is, any answer is answered in rigid language, and sometimes meaningless sounds appear.

(7) Persistence of speech

Repeat the same word or phrase in an expression, especially when a suitable expression cannot be found. For example, some patients have changed their pictures during the examination, but they still keep talking about the previous content.

(8) Imitating language

Compulsive repetition of the examiner's words is called imitation of language. For example, when the examiner asks the patient "How old are you" and the patient repeats "How old are you", most patients who imitate language still have the phenomenon of language completion. For example, when the examiner says "1, 2", the patient can count the next one; The examiner said that "the mountains cover the daytime" and then said "all rivers run into the sea". Sometimes the completion phenomenon is just an automatic response, and the patient does not necessarily understand the content.

(9) Grammatical obstacles

Grammatical expressions are mostly lists of nouns and verbs, which lack grammatical structure and cannot fully express meaning. Similar to telegraph style, when the phonetic grammar of telegraph is disordered, there are real words and function words in the sentence, but the words are wrong and the structure and relationship are disordered.

(10) fluency and fluency in speech

Generally speaking, aphasia can be divided into fluency and non-fluency according to the characteristics of patients' conversation. The changes of Benson fluency and unsmooth are shown in the table below.

The distinction between non-fluent and fluent speech

(1 1) Retelling When asked to retell the words and phrases spoken by the examiner, people with retelling disabilities cannot accurately retell the words and phrases spoken by the examiner. It is difficult for patients with complete aphasia to repeat broca's aphasia. Patients with aphasia in broca cannot accurately retell some types of aphasia, such as transcortical motor aphasia and transcortical sensory aphasia. 3. Dyslexia is called alexia because of the impairment of reading ability caused by brain lesions.

(1) Phonetic and semantic aphasia

Patients can neither read the text correctly nor understand the meaning of the text, which is manifested in the wrong matching between the text and the picture or the complete inability to match the text and the picture or the object.

(2) Phonetic aphasia

It means that you can't read the words correctly, but you understand their meaning. You can match them with pictures or objects according to words.

(3) the loss of form and meaning of reading.

Dyslexia patients who can read correctly but don't understand the meaning of the text also have difficulty reading the text at the sentence level. They can read the text correctly and match the text with the picture correctly, but they don't understand it after making sentences.

4. Writing difficulties

Writing involves not only the language itself, but also vision, hearing, movement, vision, spatial function and sports participation. Therefore, when analyzing agraphia, it is necessary to judge whether dysgraphia is aphasia. The examination items include spontaneous writing, reading, writing sentences, descriptive writing, dictation and copying aphasia. Dysgraphia often has the following manifestations:

(1) cannot be written.

It is completely difficult to write, and you can simply draw one or two strokes to form a glyph.

(2) Word formation obstacles

The written words seem to have changed, but there are strokes increasing or decreasing, or the strokes of the written words are all wrong.

(3) mirror writing

It can be seen that the right hemiplegic patient writes with his left hand, that is, the strokes are correct, but in the opposite direction, so it can be seen that the written words are the same as those seen in the mirror.

(4) writing too much

Too many words are used in oral expression, and some irrelevant words or sentences are mixed in writing.

(5) Inert writing

When you finish writing one word and write other words, you still continue to write the previous word, which is similar to the phenomenon of language retention in spoken language.

(6) hieroglyphics

Can't write, can only use pictures to express.

(7) Wrong grammar

Grammatical mistakes in written sentences are often the same as grammatical obstacles in spoken English.