Aphasia: The Cruelest Language Barrier
Imagine the following scenario: You wake up one morning and instead of speaking English, everyone around you--including your family and friends--is speaking Hungarian. This is a problem because you don't speak Hungarian and you don't have a clue what they're saying. You become frustrated. The people around you become frustrated, too, but instead of switching back to English, they speak Hungarian more loudly.
Somebody gets the bright idea of writing you a note. You take the note in your hands and study it. Unfortunately, it's in Hungarian, too, and you can't read it. So they write you another note, still in Hungarian, but this time with large, block letters. You can't read the second note, either.
This strange scenario is almost exactly what happens to people who have a stroke (circulation impairment) to the left side of the brain, except that the family and friends aren't really communicating in Hungarian. They're speaking and writing English--same as ever--but to the stroke victim their words are suddenly incomprehensible. This sudden disruption in language-processing is called aphasia.
Different patterns of aphasia occur with damage to different parts of the left side of the brain. The preceding scenario, in which comprehension of language is impaired, is called a receptive aphasia and is associated with injury to the upper portion of the brain's left temporal lobe, roughly adjacent to the temple and top of the ear. In receptive aphasia the affected individuals can still produce sentences, but, in an odd twist of fate, they can't make sense of or properly monitor their own words, so their output is riddled with errors.
A pattern of language impairment opposite of receptive aphasia is called expressive aphasia, in which individuals can understand what others say or write, but cannot produce much, if any, speech or writing of their own. In 1861 Pierre Paul Broca, a French surgeon, recognized a case of expressive aphasia and followed through with an autopsy of the patient's brain.
For much of the nineteenth century most scientists and physicians believed that the brain was homogenous, and that its different actions were spread diffusely throughout the entire brain. They did not believe that functions were localized to specific regions of the brain. (The phrenologists believed otherwise, but that is a story of its own.)
However, when Broca treated a patient who lost his power of speech (the only word he could still say was "tan") he was able to correlate this language impairment with damage to the left side of the man's brain. Instead of being in the temporal lobe, the destroyed brain-tissue was in the frontal lobe in an area now referred to as Broca's area. In fact, expressive aphasia is also known as Broca's aphasia. Dr. Broca's case was the principal salvo in a reversal of understanding about how the cerebral cortex (the brain's wrinkled gray surface) operates. Now we realize that many functions--not just language--are localized to specific regions of the cortex.
Receptive and expressive aphasias are not the only patterns of language impairment, but nicely convey the basic idea of a sudden disconnect in language processing. What becomes of these cases? As is seen with strokes affecting other parts of the brain--for example, those causing weakness or paralysis of muscles on the opposite side of the body--recovery varies widely among patients. Some patients become normal again and others don't improve at all, but the usual outcome is somewhere in between.
Improvement in language function that occurs within the first week or two following a stroke is due to brain cells that were sick from the stroke--but not quite dead--becoming healthy and operational again. By contrast, improvement in language function occurring over ensuing weeks, months and even years is due to the retraining of surviving brain cells that take over for their fallen comrades. A younger stroke patient with more brain cells in reserve has a better chance for recovery than an older patient with fewer reserves.
Is there anything that can be done to improve outcome? First of all, there is the management of the stroke itself which generally takes place in a hospital. One important point to emphasize is that a stroke causing aphasia is no less a stroke than one causing paralysis of muscles. Sometimes it seems that the latter receives more serious attention than the former. Management of fundamental issues--like blood pressure, body temperature and blood sugar--can set the stage for the best possible outcome.
Following a first stroke, physicians also implement "secondary stroke prevention" to decrease the odds of a second stroke. In cases of stroke due to hardening of the arteries (atherosclerosis) this often takes the form of ratcheting down blood pressure, blood sugar and cholesterol, along with elimination of smoking and other unhealthy behaviors. Also, the doctor usually prescribes a medicine to reduce blood-clotting. Other causes of stroke might call for other measures.
Does speech therapy help stroke-patients with aphasia? So far, this form of treatment has not been proved beneficial. Randomized, controlled trials (the standard of proof in clinical medicine in which patients receiving the treatment are compared to similar patients receiving either a dummy-treatment or no treatment) have not clearly demonstrated that speech therapy is better than either no treatment or treatment provided by family or friends.
Sometimes patients with aphasia are perceived as "confused" in the sense of having a delirium or dementia. But this is not the case. Acutely aphasic patients need to be recognized as having suffered a stroke to a specific part of the brain so they can be triaged for appropriate medical care. Over the longer term, family and friends need to remember that the stroke victim is still a perceiving, self-aware human being who happens to have a communication problem. He or she should be loved, appreciated and otherwise included in activities just as before.
(C) 2005 by Gary Cordingley
Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and researcher who works in Athens, Ohio. For more health-related articles see his website at: http://www.cordingleyneurology.com
MORE RESOURCES:
 The Sun | Klingon as a First Language FunnyCrave.com For those of you in the audience that aren't totally rad, allow me to explain to you what the Klingon language is. The Klingons are an alien race from the ... Dad spoke to son in Klingon The dad who only talked to his son in Klingon Your iPhone Speaks Klingon |
 Christian Post | Senate Tries To Strike Balance On Abortion Language 89.3 KPCC First, there was the Capps language, authored by Democrat Lois Capps of California, which stated that insurance companies could cover abortion but couldn't ... Senate Wording Angers Abortion Opponents FIRST-PERSON: Your tax dollars, funding abortion Few Americans Oppose Health Care Reform Over Abortion |
 Boston Globe | Archbishop Wuerl: Change language of same-sex marriage bill to protect ... Tips-Q GLBT News (blog) In an irenic Washington Post op-ed, Archbishop Donald Wuerl of Washington called upon city council members to change the language in impending same-sex ... White House at odds with bishops over abortion |
USC professor creates an entire alien language for 'Avatar' Los Angeles Times Today's topic: The USC professor who found himself on an unexpected Hollywood adventure when he was hired to create the language spoken by aliens on ... |
 Washington Post | Reid health bill helps chiropractors, drugmakers The Associated Press Though the precise financial impact is unclear, the language would help steer more patients to a profession whose participation in many federal programs is ... degette prefers abortion language in Senate health-reform bill Pelosi Gives High Praise To Senate Abortion Language Sen. Johanns Calls Reid's Abortion Language a "Bookkeeping Gimmick" |
 CBC.ca | PQ set to take language fight to daycares National Post MONTREAL -- Parti Québécois leader Pauline Marois has seen the enemy, and he is crawling on all fours, babbling out his first words in a language other than ... Language debate, daycares don't mix: workers Law 101 should be applied to daycares: PQ News digest |
Get to know Lindsey and the Vonntourage ESPN The group's official language is German, the first language of Vonn's two trainers, Oliver Saringer and Martin Hager, plus her ski man, Heinz Heammerle. ... |
(RATINGS: The movies listed below are rated according to the following key: 4 ... Baltimore Sun PG-13 (intense disaster sequences and some language). 2:38. 3 stars. -- MP AMELIA. This Amelia Earhart biopic isn't a bad movie, but it's distressingly ... |
 PhysOrg.com | Univision brings Spanish-language programming to YouTube USA Today Spanish language broadcast network Univision has cut a deal with YouTube to bring its programming to the online video network. Both short-form and long-form ... YouTube/Univision deal a huge resource for teachers YouTube Inks Deal With Univision (But Skips the Telenovelas) UPDATE 1-YouTube gets Hispanic shows in Univision deal |
Georgia's Pre-K Program introduces Mandarin language WALB-TV The ground-breaking program will provide daily instruction in the Mandarin language and expose children to Chinese culture. ... |
Online IELTS Preparation - Why Does It Make Sense?
Because IELTS is a difficult test. While most agree that IELTS is a reasonable test, it is generally regarded as one of the most challenging tests of its type.
Teaching Reading to English Language Learners
There is an increasing amount of English language learners represented in our schools for whom a unique approach to developing literacy is necessary. The development of literacy by English language learners (ELLs) includes all of the challenges implicit for English speaking children literacy attainments, and is additionally compounded by a diversity of linguistic, cognitive and academic variables.
What Does an Interpreter Do?
Many people get confused as to the difference between an interpreter and a translator. There is a common tendency to think translators interpreter, or that interpreters translate.
Learning a Foreign Language: Learn from the Blind
In a previous article, you read that to establih your own lists was the best way to learn vocabulary as fast as possible. Let's study what an effective list looks like.
Teaching English in Mexico: A Decent Living?
What's more disappointing than a person who makes a promise he can't keep? A person who makes a promise that is a lie. Many promises to make a "decent living" teaching English in Mexico are just that-a lie.
GROUSE ... GROUSE ... GROUSE!!!
I realize that we here in the United States consider ourselves at the top rung of the educational ladder, if only for the fact that so many foreign language students are breaking their necks to come here to both study and live English.But, on second glance, we should not deceive ourselves.
Learning a Foreign Language: Why Should you Learn Words You Never Use in Your Mother Tongue?
Imagine a child sitting in front of a desk, his head in his hands, and mumbling various lists of words over and over. Does this child remind you of your own experience? If yes, I bet that "list of words" does not sound appealing to you.
Can You Understand English?
There is a lot of talk about making English the official language of the USA. That would stop the need to spend so much money printing out things like drivers license, tax, voter registration and other official forms in so many languages.
Learn Italian in Italy
You can combine your love of the Italian language with an unforgettable experience in the country where the language is spoken by studying Italian in Italy! Hands-down, the best way to learn a foreign language is to live, work, or study in a native speaking environment. Studying Italian in Italy is the best possible experience you can have to learn the language.
Learn Italian for Free
Italian is one of the most widespread languages in the world, and speaking it can give you a tremendous sense of accomplishment, an edge in your career, and even a stronger bond with your ancestors if you are of Italian descent. There are many ways you can learn Italian, including textbooks, tapes, CDs, software, group classes or private lessons, but there are also ways you can begin or continue your studies of the Italian language entirely for FREE!1.
Chinese Pinyin or Hanyu Pinyin Overview
Chinese Pinyin is the romanization of the Chinese "written sound". Romanization approximates Mandarin pronunciation with Western spellings and includes a tone mark to signify the pitch of a word.
Show Me the Bunny: Language Acquisition
Some children are really funny about experimenting with speech. Nonetheless, the first intelligible words bring such a feeling of elation to a parent.
7 Words Americans Should Stop Using Until Further Investigation
Relationship: Here is a word that is used to qualify, justify and honey coat just about every nefarious, sleazy or reprehensible union between almost anybody and anything. Recently on an edition of the Jerry Springer show a guest was about to be interviewed who was getting it on with a very close relative.
Learn Korean: Part 1 - Asian Languages and Language Families
So, you have always been fascinated by Asian culture have you? Maybe you are someone who loves the martial arts; kung fu, tae-kwon-do, or karate. Perhaps you are interested in the cool oriental stores and like to buy many things from them to decorate your house.
Learning a Foreign Language: the Ventriloquists Lesson
The main feature you have to master, in order to call yourself a ventriloquist, is to speak without moving your lips. It is not that difficult.
Mexican Living: Todays Obsession
I would like to talk about one of my many obsessions: learning Spanish. I have been thinking about this lately mostly because I am under the impression that, though I've lived in Mexico for two years, my Spanish sucks in a major way.
Preschool Spanish
Why an EarlyAGE 2nd Language?Research indicates that from ages 1 through 8 is the best time to introduce a new language to a child. If the 2nd language is introduced early in life children will learn it faster and retain it longer.
Teaching English in Greece - What Do You Need to Know?
The employment situation can be quite uncertain for newcomers to Greece and therefore many people choose to try teaching English as a foreign language, on a full or part-time basis. It can bring in a good income whether it is your preferred career choice, or you wish to do it short-term until another career choice pans out.
Learning French in Paris
Nothing can be more frustrating than to be in France and not been able to speak their language. For, I remember the days when I was among people chanting around in a language totally alien to me, and me, trying to bring a smile in my face while shaking my head from north to south doing as if I am getting everything what they are speaking about, and waiting impatiently for my French wife to do the translation - and I can't deny, that that was not the most comfortable period of my life.
Whats In A Word? More Than You Realize
What's in a word?Apparently more than we might want.For others, the ability to express yourself in the most meaningful way.
