In the article we will consider literal paraphasia in aphasia. What do these deviations mean?
Paraphasia is a feature of aphasia (loss of speech), the characteristic symptoms of which are violations of utterance, replacement of correct syllables, letters and words with incorrect ones. The patient at the same time replaces the correct words in the composition of the sentence with completely unnatural and incomprehensible in a particular use and in a certain situation. In addition, with this pathology, there is a significant acceleration of speech, which contributes to significant difficulties in understanding the conversation.
Many people wonder that these are literal and verbal paraphasias.
Neurological aspect of the disease
The occurrence of literal paraphasia can be due to a variety of neurological causes and can be observed in people of all ages. The reasons for the development of such a disorder in adult patients include a variety of lesions of the cerebral cortex:
- brain disorderscirculation;
- injuries;
- infectious pathologies affecting the brain;
- a consequence of thromboembolism;
- cysts and other neoplasms of the brain;
- ruptured aneurysm.
In childhood, damage to the speech center of the brain should be added to the above factors, which can happen as a result of:
- maternal injury during pregnancy;
- fetal hypoxia;
- miscarriage;
- asphyxia of the newborn;
- birth injuries;
- intrauterine infection;
- somatic diseases of the mother at the stage of gestation.
At the heart of literal paraphasia are violations of the neuropsychological or neurophysiological prerequisites - it can be a disorder of praxis, phonemic hearing, articulatory apparatus, which, in turn, leads to impaired speech, perception, writing, reading, counting.
Other types of paraphasia
There are only three main types of literal paraphasia, but there is no clear line between them, since the forms can be combined with each other. Thus, the literal form of pathology is closely related to its types: verbal and mirror. Verbal paraphasias are phenomena in which one word in speech is replaced by another, and these words are in the same associative field. For example, instead of the word "elbow", they say "knee", "chair" - "table", etc.
Similarthe phenomenon is often observed in acoustic-mnestic aphasia and is distinguished by the ability to reproduce words and the inability to repeat three or four words at once, related in meaning. In such patients, there may be an increase in speech activity, or vice versa, its inhibition may appear. Difficulties caused by the semantic blurring of words, partial or complete misunderstanding of their meaning, contribute to the repeated use of paraphasias: replacing letters in words, words in a sentence, combining several words together (example: “knife” - knife and fork). Incorrect use of pronouns, change of nouns in number and gender, inflections of verbs may also appear.
Literal paraphasia manifests itself in the form of replacing a sound or letter in a word with another. A similar phenomenon occurs both in writing and in oral speech. Depending on the degree and area of the lesion, the pathological condition may acquire different features. Thus, in the case of sensory aphasia, sounds are replaced by phonemically close ones (“b” to “p”, “s” to “z”). In the case of motor aphasia, sounds are replaced with similar ones ("l" to "n", "m" to "b").
A patient with such a disease can not only confuse sounds, but also rearrange letters in one word. Often it is difficult for him to build a sentence when he needs to search for the appropriate words. Thus, the speech itself slows down, while fragments of phrases, repetitions of words are characteristic. When writing, significant deviations are also observed: its correctness and hand movements are violated. Example - voice - ear, holos, gols, etc.
Paraphasia that occurs onagainst the background of alalia (deep unformed speech due to damage to the cerebral cortex) is characterized by the loss of previously present speech, in addition, there is damage to the centers of the brain responsible for speech during fetal development.
Mirror paraphasia is characterized by the fact that the patient pronounces the end and beginning of the word correctly, and its middle - from right to left. It is characteristic that people who have such a disease very quickly read words that are written in a mirror, and they read them correctly. In certain cases, the word is read as if it is divided into several parts, where the last and first parts are pronounced correctly, and the middle part is not only mirrored, but also doubled.
Examples
When considering types of literal paraphasia in speech therapy, the following deviations may be observed:
- If the word sounds “rook”, then in the verbal form of paraphasia a person will designate this word as “swift”, “woodpecker”, “raven”.
- In the literal form - "doctor", "good luck", "grak", "grap".
- With a mirror - “garach”, “garch”.
Correction and restoration of speech functions
Treatment of any form of paraphasia, including literal, as well as any kind of aphasia, consists in the use of neurorehabilitation (compensation and restoration of higher mental functions, in particular speech). The system of therapeutic measures usually includes:
- physiotherapy;
- occupational therapy;
- drugtreatment;
- psychotherapy;
- rehabilitation classes in speech therapy;
- methods of psychological and social adaptation.
Special Scan
Currently, medical specialists prescribe a special scan to patients with literal paraphasia, according to the informational results of which it is possible to accurately determine the areas of brain damage and their degree, and then proceed to the appropriate treatment, during which not only the causes of their occurrence are eliminated, but it also becomes possible to prevent the further development of the pathological process.
Restoration of speech today is carried out by a neuropsychologist or a speech therapist-aphasiologist. The most effective classes show the use of nootropic drugs:
- "Phenotropil";
- Neotropil;
- "Encephabol";
- Cerebrolysin.
Teaching family members
However, the correction of literal paraphasia does not end there either: all members of the patient's family must undergo special training from a speech therapist-aphasiologist, receive some instructions on the features of treatment and rehabilitation of the patient. Thus, only comprehensive measures can contribute to significant positive results. The time of therapy can be significantly delayed in time - sometimes even up to five years, however, despite modern methods, treatment techniques, no specialist can guarantee a 100% result. Evenstate-of-the-art technology in certain cases cannot return the ideal state of speech.
Conclusion
Thus, a fairly common phenomenon, literal and other types of paraphasia, when a person changes letters in words, incorrectly uses them according to their meaning, is a signal to consult a qualified doctor who, after special diagnostics, can determine a specific factor lesions of the cerebral cortex and prescribe therapy and rehabilitation. This is especially important in childhood, when some parts of the brain are still forming.
