Motor aphasia in medicine has another name - Broca's aphasia, in honor of the researcher who described this disease. This is a severe speech disorder that occurs against the background of a lesion of the frontal part of the left hemisphere and a violation of its functions. Such problems most often occur as a result of a stroke or severe injuries of the skull and brain.
This pathology is expressed by severe speech defects, difficulties in choosing words in the process of speaking and, unfortunately, is not limited to articulation disorders.
What distinguishes afferent aphasia?
One of the varieties of pathological speech disorders is afferent motor aphasia, also called kinesthetic.
The patient's lower parietal parts of the brain (the leading hemisphere) are affected. In right-handed people, this is the left hemisphere, which is responsible for the process of speaking. With this type of speech disorder (in a mild form), the patient has a particular fluency of speech with no pauses between words. Whereinarticulation disorders are noticeable, as well as paraphasic defects (i.e., the replacement of some sounds or syllables in a word with others) in the process of reading or spontaneous speaking.
In a severe case, the patient has difficulty pronouncing sounds. Moreover, afferent aphasia has an interesting feature - a person, for example, can involuntarily pronounce some of them, but not at the request, since it is at this moment that he has to solve the problem of how to fold his lips, where to put his tongue, etc., to get this or that sound.
Additional signs of afferent motor aphasia
You should also pay attention to the fact that, in addition to the presence of problems with speech, in patients diagnosed with "afferent motor aphasia" oral (i.e., non-speech) praxis is also impaired.
This condition is expressed in the inability to perform various oral movements (by the way, both independently and after showing them to someone), for example, puff out both or one cheek, stick out the tongue, etc.
And as a result of a kinesthetic defect, patients also have problems with writing (both dictation and independent writing). By the way, quite often the listed disorders are also accompanied by the passivity of the patient, caused by the inertness of the processes in the nerve fibers.
What is efferent aphasia
Efferent motor aphasia is another type of speech pathology that affects the posterior part of the inferior frontal gyrus. In this case, the patient is often able to pronounce individual sounds, but to collect themin a word, "switch" from the first sound to the next, he is unable to. In patients with this type of pathology, it is the process of organizing a speech act, the so-called "kinetic melody" (as the researcher A. R. Luria said).
For such patients, "hanging" on the first sound or the first syllable of a word with subsequent long repetitions is typical. Speech loses its smoothness, selection of words is difficult, so-called emboli appear - words or sets of sounds with which the patient tries to replace everything that he is unable to pronounce.
Features of speech in efferent aphasia
And most often in the process of speech (with a diagnosis of "efferent motor aphasia") the patient uses only nouns and verbs in the initial form, for example: "House … is … stand." What such a patient says, as a rule, has a telegraphic style, but at the same time, however, the phrases turn out to be quite informative.
Correctional work with motor aphasia, by the way, often involves the use of a melodic-intonational technique. Patients are offered to sing, as well as slowly and humbly pronounce the words. And it is interesting that with such exercises (even with deep articulation disorders), the pronunciation process becomes almost normal.
Severe cases of motor aphasia
If motor aphasia is severe, then the patient's speech may consist only of slurred sounds or the words "yes" and "no". Patients try to pronouncethe entire set of phonemes available to them with different intonations, so that the interlocutor could understand their attitude to what they heard. By the way, as mentioned above, oral speech is perceived by such patients almost completely, with the exception of complex speech turns or allegories.
By the way, the emotional background of people with motor aphasia of any severity is also disturbed. Patients usually become whiny and easily fall into a state of despair or depression. Neurological signs of pathology are characterized by weakness of facial muscles, as well as the inability to simultaneously use the muscles of the face, throat and mouth. The field of view in these patients also shifts from the usual boundaries.
What is sensory aphasia
The most severe type of speech disorder is sensory-motor aphasia, or in other words - acoustic-gnostic. It is caused by damage to the posterior third of the superior temporal gyrus and is expressed in a violation of the understanding of spoken sounds, although the processes of pronunciation and articulation in patients, as a rule, are not impaired. Problems with phonemic hearing that appeared in such patients lead to a lack of control over their own speech.
It is necessary to note one more feature of this type of speech disorder - sensory-motor aphasia is characterized by the fact that, unlike the previous types of pathology, the patient is not aware of his problem.
Patients with the above diagnosis, as a rule, speak quickly, but at the same time use words in an arbitrary meaning. And all this looks to the listener as a kind ofverbal "salad", in severe cases, completely devoid of meaning.
Speech recovery in motor aphasia: what you need to remember
Practice shows that even with the same forms of aphasia in each patient, it manifests itself in different ways. It depends not only on the state of he alth and age, but also on the educational, cultural levels of a person, as well as on the characteristics of his personality.
In an acute course (after a stroke), total aphasia can immediately occur, in which the patient is unable to utter a sound. But, fortunately, speech often begins to recover over time.
At the same time, relatives who want to help an injured person should not shout when talking with him, try to encourage him to talk - he hears you perfectly. It is also not necessary, when addressing the patient, to speak in complex phrases, since the process of perceiving what was said at this time is very difficult for him. But at the same time, it should be remembered that the patient's intellect is not impaired. The problem for this person is precisely the difficulty of pronunciation!
Motor aphasia - treatment depends on many factors
Unfortunately, regaining full speech after a stroke or brain injury is quite difficult. But the patient, with the right attitude towards this, manages to restore his communication skills to a sufficient extent.
Of course, first of all, a comprehensive examination of the patient should be carried out in order to find out the cause of the violations. As you know,the method of restoring speech largely depends on which part of the brain has been damaged.
Medical therapy is also added to work with a speech therapist. With the diagnosis of "motor aphasia", treatment, as a rule, involves taking such drugs as Cavinton, Korsavin, Telektol, etc., which have a vasoactive orientation (they improve the blood supply to the brain). No less popular are anticholinesterase substances, such as "Amiridin" and "Galantamine" (they have a stimulating effect on the autonomic nervous system), as well as muscle relaxants that reduce muscle tone in paralyzed limbs (drugs "Elatin" and "Mydocalm"), and nootropic substances.
Physiotherapeutic measures in the form of acupuncture, massage, physiotherapy and electrical stimulation are also important.
How to restore speech at the initial stage
Already in the early stages after the detection of a problem, motor aphasia requires correction, since the most effective restoration of speech is possible only in the first month from the onset of the disease (later, significant positive changes, as a rule, are not noticed).
In this case, you need to try to "disinhibit" speech, to cause a speech flow in the patient. That is, those who help the patient should provoke him to pronounce at least some sounds, use all the possibilities. For example, offer to imitate any sounds: "Tell me how the water drips?" - "Kap, kap." Or: "How does the wind howl?" - "U-u-u." Moreexample: "How does the car drive?" - "W-w-w." In this case, the sounds should be strongly articulated so that the patient can understand how the speaker's lips move at the same time.
Some features of motor aphasia correction
If the patient has mild motor aphasia, do not encourage him to use gestures or facial expressions instead of words, try to stimulate speech. But at the same time, do not force things, achieve a clean and clear pronunciation. Don't constantly correct everything the patient says.
Invite the patient to speak after you, for example, the well-known sayings: "More quietly - further …" Let at first he will not be able to pronounce the whole word, even imitation of sounds is enough, which will cause an impulse to speak. Photographs of loved ones will also help. You need to ask someone to show them and say his name.
As soon as the disinhibition has begun, try to use verbs, connect all types of communication: speech, writing, reading. For example: "What is the cat doing?" - "Asleep." Let the patient not only pronounce the given word, but also find among the proposed signatures the one that matches the picture.
What to do in case of severe aphasia
As mentioned above, a severe degree of aphasia leads to the fact that a person is not able to pronounce even a syllable, and not just a word. In this case, he will need an ordinal count, repeating the names of the days of the week, or singing.
The fact is that these processes are the most automated, andcontrol over them passes to other parts of the brain. Therefore, counting after you: "One, two, three, four," the patient utters sounds without hesitation. By the way, the same thing happens in the process of singing. The song should be familiar and as simple as possible. First sing along with the patient, and then encourage everyone, even vague attempts to sing or count independently.
Remember that at all stages of rehabilitation, patients need encouraging conversations and positive motivation for classes, since the emotional factor is an important component that successfully overcomes motor forms of aphasia.
A final word
The work of restoring speech is a rather lengthy and difficult process. It requires the joint efforts of the attending physician, speech therapist and, of course, the victim's close circle. Moreover, the correction of motor aphasia must be carried out at a professional level, and the earlier it is started, the more chances for success.
Especially pronounced positive dynamics in young patients. And a spontaneous exit from the state of motor aphasia, by the way, may be accompanied by the onset of stuttering.
Consider all this, do not lose faith in success - and you will succeed!
