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Conversational Speech Fluent, normal utterance length and well-formed sentences Fluent with normal utterance length !ut has paraphasias
Auditory comprehension Good for everyday conversation, difficulty with complex syntax Good for casual conversation, difficult with complex syntax
Repetition preserved
Lesion Location Acute outside perisylvian zona (angular gyrus or inferior temporal region), chronic- perisylvian area, posterior tempolateral region "osterior perisylvian lesions affecting supramarginal gyrus in parietal lo!e and arcuate fasciculus
onduction Aphasia
fluent
fluent
Fluent
.onfluent
Fluent with normal utterance length, !ut semantic paraphasias, anomia Fluent, easily articulated speech of normal utterance length, semantic and phonemic paraphasias, ver!al output excessive and rapid !ut empty ,ittle attempt to produce spontaneous speech, mute, speech is reduced in length $low, halting speech production, utterances are of reduced length with simple grammar Conversational Speech
Significantly impaired
Always impaired
$everely impaired
Severely impaired at single-word level, difficulty with complex syntax and multi-step commands, unaware of ina!ility to produce coherent speech Good for most conversational interaction, difficulty with complex syntax Good for conversational speech, difficulty with complex syntax Auditory comprehension
%xtrasylvian regions involving "&# 'unction region( posterior and deep to )ernic*e+s area( sensory info doesn+t reach language areas ,arge posterior perisylvian lesions encompassing )ernic*e+s area and extending superiorly into inferior parietal region
"reserved, !ut a!sence of spontaneous speech ,imited to single words and short phrases
/elatively preserved
.onfluent
Type of Aphasia
Fluent or Nonfluent
Repetition
%xtrasylvian regions of left frontal lo!e( dorsolateral frontal lesions located anterior or superior to 0roca+s area, supplementary motor areas, cingulate gyrus 0roca+s area causes transient disruption of speech production and fluency( persistent 0roca+s aphasia from larger perisylvian lesions encompassing more of the left frontal lo!e Lesion Location
-ixed transcortical aphasia (-#cA), isolation syndrome perisylvian zone disconnected from extrasylvian regions
nonfluent
-eaningful ver!al expression is severely limited or a!sent, inappropriate repetition of what other say
$ignificantly impaired
3iffuse4mulitfocal lesions resulting in anatomic isolation of perisylvian language from surrounding cortical areas (periphery of middle cere!ral artery distri!ution)
Other Aphasias - su cortical regions include thalamic aphasia, !asal ganglia aphasia, surrounding white matter aphasia ! associated with dementia( Al"heimer#s disease language deterioration follows progressive course !eginning with anomic aphasia transcortical sensory aphasia )ernic*e+s aphasia glo!al aphasia - primary progressive aphasia $%%A& progressive language deterioration without significant dementia