Speech loss causes in adults. Features of speech disorders in adults. How does a stroke occur?

THE ARTICLE WILL HELP YOU UNDERSTAND THE CAUSES OF SPEECH LOSS, BECAUSE WHO DIAGNOSES CORRECTLY TREATS CORRECTLY. Sudden loss of speech can be caused by the reasons listed below. By checking one by one and rejecting one by one the reasons that are not relevant to your case, only your case will remain. The prognosis of health and life largely depends on timely recognition.

THE FIRST MANDATORY STEP IS DETECTING THE LOCATION OF THE BRAIN FOCUS IN THE EVENT OF SUDDEN LOSS OF SPEECH, IF THE FOCUS IS PRESENT

In case of damage to the postcentral parts of the dominant hemisphere, receiving information from receptors that communicate information from the speech-motor apparatus and ensure the coordinated functioning of the speech-motor apparatus, loss of speech occurs - afferent motor aphasia. When this part of the brain is damaged, there is a violation of the coordination of the muscles involved in the formation of speech, and errors appear when pronouncing individual speech sounds, more pronounced if there is a similar phonetic pronunciation (for example, front-lingual “t”, “d”, “n”; fricative “sh”, “sch”, “z”, “x”; labial “p”, “b”, “m”).

Because of this, spontaneous speech turns out to be illegible, numerous sound substitutions appear in it, which makes it incomprehensible to others, while the patient himself is not able to control it due to a kind of sensitive ataxia in the structures that ensure the emergence of speech. Afferent motor aphasia is usually combined with oral (buccal-lingual) apraxia (the inability to reproduce on instructions movements of the tongue and lips that require significant precision - placing the tongue between the upper lip and teeth, etc.) and is characterized by a violation of all types of speech production (spontaneous speech , automated, repeated, naming).

In case of damage to the posterior parts of the inferior frontal gyrus (Broca's area) sometimes - efferent motor aphasia. In this case, articulation of individual sounds is possible, but switching from one speech unit to another is difficult. The patient’s speech is slow, he is laconic, there is poor articulation, requiring significant effort from him, his speech is replete with numerous literal and verbal perseverations (repetitions), which is manifested, for example, by a disorder in the ability to alternate individual syllables (ma-pa-ma-pa). Due to the omission of auxiliary words and case endings, the patient’s speech sometimes becomes “telegraphic.” With pronounced manifestations of this form of aphasia, it is possible for patients to form “speech emboli” - repetition of certain words (often swear words), which the patient pronounces “out of place,” while conveying his attitude to the situation through intonation. Sometimes the patient is able to repeat individual words after the examiner, but he cannot repeat a phrase, especially an unusual one, devoid of meaning. The nominative function of speech (naming objects), active reading and writing are impaired. At the same time, understanding of oral and written speech is relatively intact. Fragmentary automated speech and singing may be preserved (the patient can hum a melody).

Patients, as a rule, are aware of the presence of a speech disorder and sometimes have a hard time experiencing the presence of this defect, showing a tendency to depression. With Broca's efferent motor aphasia, there is usually hemiparesis on the side opposite the dominant hemisphere, while the severity of paresis is more significant in the hand and face (brachiofacial type).

Dynamic motor aphasia occurs with damage to the prefrontal region anterior to Broca's areas and is characterized by a decrease in speech activity and initiative. At the same time, reproductive (repetition of words and phrases after examination) and automated speech suffer significantly less. The patient is able to articulate all sounds and pronounce words, but his motivation to speak is reduced. This is especially clear in spontaneous narrative speech. Patients seem to be reluctant to enter into verbal contact; their speech is simplified, reduced, and exhausted due to the difficulty of maintaining a sufficient level of mental activity in the process of verbal communication. Activation of speech in such cases is possible through a stimulating effect on the patient, in particular a conversation on a topic that has a high degree of personal significance for the patient. This form of speech loss can be explained as a consequence of a decrease in the influence on cortical structures from the activating systems of the reticular formation of the oral parts of the brain stem.

Sensory aphasia, or acoustic-gnostic aphasia, occurs when Wernicke's area, located in the posterior part of the superior temporal gyrus, is damaged. Sensory aphasia is based on a disorder of speech recognition in the general sound stream due to a violation of phonemic hearing (phonemes are units of language with the help of which its components are distinguished and equated; in Russian speech these include voiced and deaf, stressed and unstressed). In this case, there is a violation of sound-letter analysis and alienation of the meaning of words.

With sensory aphasia, the ability to repeat words is also lost. A patient with sudden loss of speech in the form of sensory aphasia cannot correctly name familiar objects. Along with the impairment of the patient’s oral speech, the ability to understand written speech and read is also impaired. Due to a phonemic hearing disorder, a patient with sensory aphasia makes mistakes when writing, especially when writing from dictation. In this case, first of all, letter substitutions are characteristic, reflecting stressed and unstressed, hard and soft sounds. As a result, the patient’s own written speech, like oral speech, seems meaningless, but the handwriting may remain unchanged.

In typical, isolated sensory aphasia, manifestations of hemiparesis on the side opposite the dominant hemisphere may be absent or mild. However, superior quadrant hemianopsia is possible due to the involvement of the lower part of the optic radiation in the pathological process passing through the temporal lobe of the brain.

Semantic aphasia occurs when the inferior parietal lobule is damaged. It is manifested by difficulties in understanding phrases that are somewhat complex in construction, comparisons, reflexive and attributive logical-grammatical phrases expressing spatial relationships. The patient is not oriented in the semantic meaning of prepositions and adverbs: under, above, before, behind, above, below, lighter, darker, etc. It is difficult for him to understand the difference between the phrases: “The Sun is illuminated by the Earth” and “The Earth is illuminated by the Sun,” “Father’s brother” and “Brother’s father”, give the correct answer to the question: “If Vanya follows Petya, then who goes ahead?”, draw a triangle in a circle, a cross over a square, etc. according to the instructions.

Amnestic (anomic) aphasia is observed when the posterior parts of the parietal and temporal lobes of the left hemisphere, mainly the angular gyrus, are damaged, and is manifested by the inability to name objects; in this case, the patient can correctly speak about their purpose (for example, when the examiner asks to name the pencil being shown, the patient states: “Well, this is what they write with” and usually tries to show how it is done). The hint helps him remember the right word for the name of the object, and he can repeat this word. The speech of a patient with amnestic aphasia has few nouns and many verbs. At the same time, active speech is fluent, understanding of both oral and written speech is preserved. Concomitant hemiparesis on the side of the subdominant hemisphere is uncommon.

Total aphasia is a combination of motor and sensory aphasia: the patient does not understand speech addressed to him and at the same time he himself is unable to actively pronounce words and phrases. It develops more often with extensive cerebral infarctions in the basin of the left middle cerebral artery and is usually combined with severe hemiparesis on the side of the hemisphere opposite to the dominant one.

It was proposed to take into account the often clinically encountered manifestations of minimal dysphasia, or preaphasia, in which a speech defect manifests itself so easily that during a normal conversation it can go unnoticed by both the speaker and his interlocutor. Preaphasia is possible both with increasing brain pathology (atherosclerotic encephalopathy, brain tumor, etc.), and in the process of restoration of impaired functions after a stroke, brain injury, etc. (residual dysphasia). Its identification requires particularly careful research. It can manifest itself in the form of speech inertia, spontaneity, impulsiveness, decreased ability to quickly and easily select the right words, and the use of predominantly words that appear in the patient’s dictionary with great frequency. At the same time, rarer words are recalled with difficulty and with delay, and the patient often replaces them with more frequently occurring, although less appropriate words in the given context. In the speech of patients, “clichéd” words and phrases, speech “cliches,” and habitual speech patterns become abundant. Not finding the exact words and phrases in a timely manner, the patient tends to substitute words (“well, this thing, what’s it like”) and thus compensate for the lack of quality of his speech with an excessive amount of speech production, and therefore excessive verbosity manifests itself. If the patient performs individual tasks correctly, then performing a serial task (for example, touching the bridge of the nose with the index finger of the right hand, holding oneself by the right ear with the left hand and closing the left eye) is difficult. Verbally presented material to patients is poorly interpreted and inaccurately repeated; difficulties arise in explaining the meaning of such generally accepted expressions and proverbs as “golden hands”, “take the bull by the horns”, “there are devils in still waters”, etc. Difficulties may occur when listing objects belonging to a certain class (animals, flowers, etc.). Speech disorders are often identified when the patient compiles an oral or written story based on a picture or on a given topic. In addition to other difficulties, in the process of communicating with a patient, uncertainty in the perception of a verbal task and the resulting slowness of reactions to it may be noted.

THE SECOND MANDATORY STEP IS TO FIND OUT THE MAIN CAUSE OF THE SUDDEN LOSS OF SPEECH:

Loss of speech almost always occurs with a left-hemisphere stroke. It can also be observed in the right hemisphere (i.e., when the hemisphere opposite to the dominant one is damaged), but in these cases speech is restored much faster.

3 The cause of sudden loss of speech is a condition after a seizure.

At any age, acute sudden loss of speech can be caused by a condition following a seizure.

In these cases, speech is quickly restored.

The epileptic seizure itself may go unnoticed, and the bite of the tongue or lips may be absent;

EEG helps to diagnose the condition after a convulsive seizure as the cause of loss: generalized or local slow and sharp wave activity is recorded.

An increase in the level of creatine phosphokinase in the blood is unreliable as a diagnosis of an epileptic seizure.

4 In young patients, sudden loss of speech may be caused by migraine with aura.

In 60% of cases, during the collection of a medical history, the patient’s relatives also have migraine headaches.

In these cases, acute or subacute speech loss occurs simultaneously with the headache.

Speech difficulty is a speech disorder that interferes with a person's normal verbal communication and social interaction with others. We can talk about the presence of disorders when there are deviations in the functioning of the psychophysiological mechanisms of speech, if the level of speech development does not correspond to the age norm, or with speech deficiencies that negatively affect mental development and cannot be overcome independently. Speech therapists, as well as neurophysiologists, neurologists, otolaryngologists and other specialists study and treat speech difficulties in adults and children.

Symptoms and manifestations

This pathology can be expressed either in a complete absence of speech, or in a violation of the pronunciation of specific phrases and words. In addition, the following symptoms are present:

• speech is unclear and slow, it is unintelligible;
• the patient has difficulty choosing words and naming things correctly;
• speech is possible quickly and without hesitation, but completely meaningless;
• there is haste and incoherence of thinking;
• a person strongly separates syllables and places stress on each of them.

Causes in adults

Speech impairment may develop suddenly or gradually. There are the following main reasons that can lead to this pathological process:

• improper functioning of the brain (in particular, the basal ganglia - those parts of the brain that are responsible for the movements of the body muscles and speech);
• brain injuries caused by stroke or thrombosis;
• head injuries;
• the presence of tumors in the brain;
• the presence of degenerative diseases in which cognitive functions are impaired (these include dementia and Alzheimer's disease);
• Lyme disease;
• excessive consumption of alcoholic beverages;
• weakness of the facial muscles, for example, Bell's palsy;
• too weak or tight fastening of dentures.

Types of speech disorders in children

All speech difficulties in children are divided into two types:

1. Phonation (external) design of the utterance - this includes speech pronunciation disorders;
2. Structural-semantic (internal) design of a statement is a systemic or polymorphic speech disorder.

Disturbances in the speech process of phonation design of utterances can be either individual or combined. Based on this, speech therapy distinguishes the following types of disorders:

1. Aphonia and dysaphonia are a disorder or complete absence of phonation due to various pathological changes in the vocal apparatus. This condition is characterized by a violation of the strength, pitch and timbre of the voice or a complete absence of phonation. Aphonia and dysaphonia can be caused by functional or organic disorders of the voice-forming mechanism and occur at various stages of child development.
2. Bradylalia is a pathological slowing of speech rate. A characteristic feature is the slow implementation of the articular speech program.
3. Tachylalia is a pathological acceleration of speech rate. Characterized by accelerated implementation of the articulatory speech program.
4. Stuttering is a disorder of speech organization in which the muscles of the speech apparatus are in a convulsive state. The pathology is centrally determined and appears, as a rule, in the process of the child’s speech development.
5. Dyslalia - pathology is a disorder of the pronunciation of sounds, in which hearing remains normal, as well as the innervation of the speech apparatus. Clinically manifests itself in the form of distorted sound design of speech, with incorrect pronunciation of sounds or their replacement and confusion.
6. Rhinolalia is a violation of the pronunciation of sounds and voice timbre, caused by anatomical and physiological disorders of the speech apparatus. A pathological change in voice timbre is characteristic, accompanied by the passage of a vocal stream of air during exhalation and in the process of pronouncing sounds into the nasal cavity. This leads to the formation of resonance in the latter.
7. Dysarthria is a pronunciation disorder, the distinctive feature of which is insufficient innervation of the speech apparatus. For the most part, this pathology develops as a result of cerebral palsy that appears at an early age in the child.

Speech difficulties of structural and semantic design are divided into two types: alalia and aphasia.

• Alalia is the absence or insufficient development of speech, provoked by damage to the areas responsible for speech located in the cerebral cortex during fetal development or at an early age of the baby.

It should be noted that alalia is one of the most severe speech defects, which manifests itself in violations of the selection and analysis operation at all stages of birth, as well as the reception of speech utterances, as a result of which the child’s speech activity is not fully formed.

• Aphasia is a complete or partial loss of speech, which is caused by local brain lesions. The ability to speak normally may be lost due to traumatic brain injury, neuroinfection, or brain tumors after speech is formed.

Diagnostics

First of all, it is necessary to analyze the complaints presented by the patient, as well as the medical history. It is important to take into account how long ago complaints of quiet, slow speech and difficulties in pronouncing words and phrases arose, and whether the patient’s immediate relatives have similar manifestations.

Then it is necessary to undergo an examination by a neurologist, which consists of checking the mandibular and pharyngeal reflexes, examining the pharynx, and the presence of thinning (atrophy) of the tongue muscles. In addition, it is important to check the reflexes of the lower and upper extremities.

You need to undergo an examination by a speech therapist; the doctor will be able to evaluate speech indicators, determine the presence of tempo disturbances, as well as difficulties in pronouncing specific sounds.

An examination by an otolaryngologist helps to exclude various space-occupying processes (ulcers and tumors) in the nasal cavity, as they can also affect the voice.

Using computed tomography and magnetic resonance imaging of the head, it is possible to conduct a layer-by-layer study of the structure of the brain and determine the cause of dysarthria (these could be tumors, areas of impaired blood circulation, ulcers, areas of myelin decay - the main protein of nervous tissue).

In some cases, it is additionally necessary to consult a neurosurgeon.

Treatment

Therapy for speech disorders consists of treating the main disease that provoked dysarthria:

• the tumor must be removed surgically;
• resection of a hematoma (hemorrhage) is possible if it is located on the surface;
• surgically remove ulcers from the cranial cavity, and then prescribe antibacterial drugs to stop the infectious process as soon as possible;
• normalize blood (arterial) pressure, use drugs that improve metabolism and cerebral blood flow (nootropic drugs, angioprotectors) in case of cerebrovascular accident.

And, of course, patients with any kind of speech difficulties need to go to a speech therapist to correct the existing defect with the help of specially selected exercises.

For many, the ability to talk is a means of communication with other people and the world around them.

Therefore, if a person loses this ability, he must first find out the reason, and then undergo comprehensive treatment.

If you do not catch it in time, the patient may experience permanent dysfunction of the speech apparatus.

Causes of speech disorders in adults

Speech impairment in adults is a pathology that manifests itself in the complete or partial absence of speech.

In a conversation with a person suffering from such an illness, it is impossible to understand what he is saying or asking; his words are illegible and unclear.

This pathology manifests itself differently in each person. In some people, such violations cause hasty, but completely meaningless speech, while others, on the contrary, construct sentences logically and constructively, but at the same time speak very slowly and unhurriedly.

The main causes of speech impairment in adults:

1. Previously suffered brain injuries;
2. The presence of benign or malignant formations in the brain;
3. Wilson's disease;

Banal dentures can also be a cause. If improperly secured, elderly people experience dysfunction of the speech apparatus.

Speech impairment in an adult can also occur due to diseases that cause paresis of the facial muscles.

Paresis is a neurological syndrome indicating a decrease in strength. Such diseases include Millard-Jublet syndrome, Mobius syndrome, muscle agenesis, Beck's disease and Sjögren's syndrome.

Myasthenia gravis can also cause problems. This is an autoimmune neuromuscular disease that is characterized by pathologically rapid fatigue of the transverse sucking muscles.

Some diseases cause not only paresis of the facial muscles, but also impaired articulation and speech in adults.

This pathology occurs with Foix-Chavanne-Marie syndrome. With this disease, the middle cerebral artery basin is affected.

One of the most common causes of speech impairment in adults is Alzheimer's disease.

With this disease, dementia (acquired dementia), partial memory loss, and articulation difficulties are observed. Most often, this disease affects people over 65 years of age.

There are the following types of speech disorders in adults:

• Dysphonia;
• Aphonia;
• Bradylalia;
• Tahilalia;
• Stuttering;
• Dislalia;
• Dysarthria;
• Alalia;
• Aphasia.

Spasmodic dysphonia

This pathology is more common in people aged 30 to 40 years. Dysphonia is a voice disorder characterized by hoarseness.

Spasmodic dysphonia occurs due to prolonged overstrain of the vocal cords.

Also, the cause of this pathology may be mental trauma.

With this form of dysphonia, pain is observed in the neck and head muscles, and the timbre of the voice changes significantly. The disease manifests itself in slurred speech and difficulty pronouncing certain sounds.

Aphonia

Aphonia is a pathological condition with loss of vocal sonority.

With this pathology, a person remains able to speak in a whisper, but when speaking he experiences a sore throat.

Aphonia occurs due to bronchial diseases or laryngitis. This pathology can also occur with prolonged screaming or intubation.

Bradylalia

Bradylalia is a disturbance in the rate of speech production. In other words, with this disease the rate of speech is very slow. Articulation in bradyllalia is unclear.

This disease occurs due to Parkinson's disease, brain tumors, meningitis and encephalitis.

Bradylalia can also be hereditary or appear after brain injury.

Tahilalia

Tahilalia is a disorder that manifests itself in a fast pace of oral speech.

With this disease, a person does not make grammatical or phonetic errors in pronunciation.

The causes of tachyhalea can be:

1. Chorea disease.
2. Oligophrenia.
3. Skull injuries.
4. Heredity.
5. Formations in the brain.
6. Myelitis.
7. Tetanus.
8. Arachnoiditis.

Stuttering

Stuttering is a disease that manifests itself in the form of impaired speech function.

When a person stutters, he stretches out syllables and pronounces words incorrectly.

Causes:

• Brain damage.
• Stress.
• Heredity.

Dislalia

With dyslalia, a person reproduces sounds incorrectly. This disease appears due to the presence of a defect in the structure of the speech apparatus (bad bite, shortened hyoid frenulum, abnormal structure of the palate, and others).

Dyslalia also occurs due to illiterate speech education or in connection with mental development disorders.

Most often, this disease occurs in children, but it also occurs among adults. In adults, dyslalia appears due to low mobility of the speech apparatus.

Dysarthria

Dysatria occurs due to damage to the central part of the speech motor analyzer.

With this disease, there is a disorder of articulation, phonation and speech.

Dysatria occurs due to cerebral palsy, neurosyphilis, multiple sclerosis and myotonia.

A similar speech disorder occurs in adults with a stroke and after neurosurgical operations.

Alalia

Alalia is an underdevelopment of speech due to damage to the speech centers of the brain.

The main reasons for the appearance of alalia in people over 20 years of age are operations using general anesthesia, previous traumatic brain injuries and malnutrition.

Aphasia

Aphasia is a complete or partial loss of the ability to reproduce words and sounds. This disease occurs due to damage to the cerebral cortex.

Aphasia appears due to impaired blood circulation in the brain, with the formation of a brain abscess, after strokes and heart attacks.

Epilepsy or acute intoxication with toxic substances can also cause the development of the disease.

A patient with aphasia has difficulty recognizing speech, has problems concentrating, and has problems reading and remembering.

Treatment of speech disorders

Treatment for speech disorders in adults is selected based on the type of disorder itself.

Treatment mainly involves massage, physiotherapy, exercise therapy and medication.

Medication

Treatment of dysarthria involves exercise therapy and medication. It is very important that the patient’s treatment is also accompanied by a speech therapist.

Drugs for the treatment of dysarthria:

1. "Piracetam."
2. "Finlepsin".
3. "Lucetam."

If an adult has inhibited speech after a stroke, that is, dysarthria, then it is necessary to do daily language exercises.

To treat aphasia, nootropic drugs and drugs that improve microcirculation in brain tissue are used.

Preparations:

• "Vinpocetine."
• "Piracetam."

For aphasia, working with a speech therapist is mandatory. Typically, to fully restore the ability to speak, you will need to be treated by a speech therapist for at least 3 years.

Piracetam - for the effective treatment of speech disorders

Stimulant medications are prescribed to treat dysphonia:

1. Prozerin.
2. Tranquilizers.

Other drugs for the treatment of speech disorders:

• "Vinpotropil."
• Cavington.
• "Memotropil."
• "Nootropil"

Medical therapy should include medications that improve memory and enhance metabolic processes in the central nervous system.

It is extremely rare that surgery is used to treat such diseases. Surgery is necessary to remove tumors and other formations that provoked the disorder.

Speech impairment in an adult after stress requires not only exercise therapy and medication, but also a visit to a qualified psychotherapist or psychologist. It is likely that the person himself, after experiencing the situation, on a subconscious level put a barrier to speech reproduction.

Treatment at home

Traditional medicine can also be used to treat speech disorders.

If a person has dysarthria, then the following recipe will help: 1 tbsp. l. dill seeds are poured with boiling water and infused for 15 - 20 minutes.

Then the infusion is filtered and cooled. It should be taken 15 minutes before meals in the amount of 1 tsp. Use the product no more than 5 times a day.

If an elderly person has slow speech, for example, after a stroke, then you can make a tincture of ginseng, buckwheat and Echinops.

Exercise therapy plays a major role in the treatment of speech disorders. The patient should do exercises daily if the cause of the disorder is paresis of the facial muscles.

1. exercise: stretch your lips, curling them into a tube. Hold in this position for 5 seconds, then repeat;
2. exercise: grab the upper lip with your lower jaw, hold it for 3 seconds, then release;
3. exercise: close your mouth. The tongue reaches the palate.

Conclusion

Treatment of a speech disorder is a long process. It is very important that, along with doctors and speech therapists, the patient is helped at home.

People with such problems should express their thoughts clearly and slowly, and not be negative or dismissive.

Video: Treatment of aphasia

For every person, speech is an integral part of normal interaction with others, and any deviation in speech function can lead to psychological problems associated with the impossibility of personal self-realization.

Dysfunction of the speech apparatus has a direct impact on the life activity of any person, and therefore it is very important to promptly diagnose the pathology at the slightest deviation in order to avoid serious complications in the future.

Speech impairment is a violation of speech function, which can be caused by completely different reasons. This term includes various types of deviations in human speech development, which can lead to either complete or partial loss of reproduction of words and sounds.

Conventionally, speech disorders in medical practice are divided into two main groups:

• Organic reason for the development of deviations. The causes of speech dysfunction in this case are internal anatomical pathologies affecting the structure of the speech apparatus. For example, birth or mechanical damage to areas of the brain responsible for speech functions, abnormal structure of the speech apparatus, hereditary disposition, etc.;
• Functional reason for the development of deviations. In this case, the normal functioning of the speech apparatus is disrupted due to certain external factors. For example, prolonged stress, abnormalities in the functioning of the nervous system, infectious diseases, head injuries, mental disorders, etc.

Deviations can manifest themselves in the form of expressive speech, slowness in pronunciation, nasality or stuttering. To identify the causes of disorders, consultation with a neurologist, speech therapist and diagnostics are required.

Classification of speech deviations

There are several main forms of speech disorders in adults encountered in medical practice. Depending on the type of speech defect, specific work is always required to eliminate deviations, since the lack of proper treatment at any time can lead to a complete loss of speech function or psychological deviations.

The main classification of speech disorders includes several forms of deviations in speech development:

Stuttering is considered one of the main types of speech deviations. The reasons for the development of this pathology are factors such as stress, fear, neurological abnormalities, genetic disposition, and severe emotional shock.

Speech dysfunction is characterized by such signs as constant disruptions in the rhythm of speech caused by spasms or convulsions of some parts of the speech apparatus. When a person stutters, there is difficulty pronouncing words and sounds, as a result of which he is forced to constantly take long pauses and repeat the same sound or syllable several times.

In order to identify the form of the disease, it is necessary to understand what reasons serve as the impetus for the development of speech abnormalities.

Causes of development of abnormalities in adults

There are many internal and external factors that provoke deviations in speech pronunciation. Moreover, depending on the cause of speech impairment, the process of development of deviations can be both rapid and gradual. The most common reasons for dysfunction are:

• severe pathologies affecting the brain: with intracranial high pressure, a stroke may occur, the main consequence of which may be a violation of speech functions;
• in the course of impaired coordination of movements caused by damage to the cerebellum of the brain (for example, a heart attack or cerebral ischemia), an organism reaction such as complete or partial loss of speech may occur;
• mechanical damage and trauma to the head and face, in particular in children during childbirth;
• brain pathologies caused by thrombosis;
• dysfunction of the parts of the brain responsible for speech and movement;
• various types of degenerative pathologies of the nervous system and brain (Alzheimer’s, dementia, tumors, etc.);
• genetic disposition;
• disruptions in the functioning of the central nervous system;
• birth injuries, during which speech functions are damaged;
• alcoholism can cause problems with speech;
• facial paralysis;
• atherosclerosis;
• pathologies of the muscular articulatory and motor speech apparatus (low mobility of the lips, tongue, facial muscles);
• improper fastening of the denture;
• decreased tone of the soft palate;
• stress, fear, prolonged depression;
• some infectious diseases;
• developmental delay, dementia;
• disruption of blood circulation;
• cerebral palsy;
• mental retardation;
• deafness;
• frequent neuroses;
• Down syndrome;
• Lyme disease;
• long-term use of certain medications (antidepressants, antibiotics).

It should be remembered that the causes of speech disorders can be of a physiological, social and psychological nature.

Signs of abnormalities

It should be noted that more severe cases of speech impairment that occur with dementia and certain psychological abnormalities in the body, regardless of the patient’s age, can provoke muteness. Therefore, it is very important to recognize the primary signs in a timely manner in order to prevent the disease from progressing.

1. Inconsistency of the language norm with the age of the speaker.
2. Spastic dystrophy is manifested by involuntary vibrations of the patient’s vocal cords. In this case, abnormalities in speech may be accompanied by initial signs such as hoarseness, a muffled voice, or a breathy sound of speech.
3. With aphasia, a person is completely unable to express his thoughts competently and quickly. The patient has problems perceiving the speech of people around him. A person suffering from speech disorders takes a very long time to formulate his thoughts and express them in words. The words and sounds he pronounces are incorrect and indistinct.
4. A speech rate that is too fast, or, conversely, too slow, can be evidence of dysfunction in the patient’s speech apparatus. This may be the result of a complex mental illness; TNR caused by brain pathologies; infectious diseases or degenerative conditions.
5. Another syndrome of the disease is a violation of the timbre of the voice. Any change in the function or shape of the vocal cords can provoke changes in the articulation and pronunciation of individual sounds, as well as lead to ease of speech during pronunciation.
6. Due to the weakness of the speech apparatus and vocal muscles, signs such as speech inhibition and “swallowing” of sounds appear.
7. Problems can manifest themselves in the form of expressive speech - rapid and frequent repetition of the same words, increased speech activity that is unusual for a normal person, disruption of the syntactic structure of phrases and fluency of pronunciation.
8. Nasality, stuttering, inability to pronounce a word or phrase, repeated pronunciation of sounds are the main signs of speech abnormalities.

It should be noted that intellectual-mnestic functions, which represent various forms of mental disorder, are degrading in nature. Often, with this form of the disorder, brain cells are affected, which negatively affects the patient’s speech function. As a result of such complex pathologies as a cerebral infarction or stroke, an adult patient may, over time, develop severe impairment of speech functions, up to complete numbness. Therefore, it is so important to promptly consult a specialist at the slightest manifestation of symptoms.

Treatment

As soon as the cause of the pathology is identified and a diagnosis is made, the doctor will prescribe appropriate treatment, the main principle of which is to eliminate the causes that caused speech dysfunction.

As for children, a speech therapist can help correct speech defects at an early age. But only if the deviations are not associated with mental disorders and mechanical damage to the head. It is important to understand here that the older the patient and the more complex the cause of speech abnormalities, the longer the process of treatment and correction of speech abnormalities will be.

Treatment methods are as follows:

1. Conservative treatment. This includes classes with a speech therapist, the use of special exercises to restore speech and articulation exercises, as well as physiotherapeutic procedures.
2. Drug treatment. It comes down to improving cerebral blood flow, normalizing blood pressure and enhancing metabolic processes in the central nervous system. Drugs that influence the process of improving memory, attention and perception of the patient are also used.
3. The last resort is surgery. Which involves the removal of tumors and ulcers in the cranial cavity, resection of hematomas and elimination of other growths that provoked the occurrence of deviations of the speech apparatus as a result of dangerous diseases. Surgery is used only when all other treatment methods have failed to produce the expected result.

The choice of a specific treatment method, medications and the appropriateness of the operation is determined by the doctor, depending on the form of the pathology and the stage of concomitant diseases.

There is a separate branch of psychology that studies people suffering from speech disorders - logopsychology. The psychology of people who have speech disorders requires a systematic and thorough study of the symptoms, signs and mechanisms of development of this disorder. Thanks to this, it is possible to achieve positive results through the development of special methods of psychological assistance and suitable treatment regimens in each specific case.

It should be understood that any defects and speech disorders, as well as damage to areas of the speech apparatus, if untimely or incorrectly treated, can lead to underdevelopment of speech, decreased communication and attentiveness, as well as limiting the patient’s logical and mental conclusions.

Causes of slurred speech in the elderly

THE ARTICLE WILL HELP YOU UNDERSTAND THE CAUSES OF SPEECH LOSS, BECAUSE WHO DIAGNOSES CORRECTLY, TREATS CORRECTLY. Sudden loss of speech can be caused by the reasons listed below. By checking one by one and rejecting one by one the reasons that are not relevant to your case, only your case will remain. The prognosis of health and life largely depends on timely recognition.

THE FIRST MANDATORY STEP IS TO IDENTIFY THE LOCATION OF THE BRAIN FOCUS IN THE EVENT OF SUDDEN LOSS OF SPEECH, IF THE FOCUS IS PRESENT

When the post-central sections of the dominant hemisphere, which receive information from receptors that communicate information from the speech-motor apparatus and ensure the coordinated functioning of the speech-motor apparatus, are damaged, loss of speech occurs - afferent motor aphasia. When this part of the brain is damaged, there is a violation of the coordination of the muscles involved in the formation of speech, and errors appear when pronouncing individual speech sounds, more pronounced if there is a similar phonetic pronunciation (for example, front-lingual “t”, “d”, “n”; fricative “sh”, “sch”, “z”, “x”; labial “p”, “b”, “m”).

Because of this, spontaneous speech turns out to be illegible, numerous sound substitutions appear in it, which makes it incomprehensible to others, while the patient himself is not able to control it due to a kind of sensitive ataxia in the structures that ensure the emergence of speech. Afferent motor aphasia is usually combined with oral (buccal-lingual) apraxia (the inability to reproduce on instructions movements of the tongue and lips that require significant precision - placing the tongue between the upper lip and teeth, etc.) and is characterized by a violation of all types of speech production (spontaneous speech , automated, repeated, naming).

When the posterior parts of the inferior frontal gyrus (Broca's area) are damaged, efferent motor aphasia occurs. In this case, articulation of individual sounds is possible, but switching from one speech unit to another is difficult. The patient’s speech is slow, he is laconic, there is poor articulation, requiring significant effort from him, his speech is replete with numerous literal and verbal perseverations (repetitions), which is manifested, for example, by a disorder in the ability to alternate individual syllables (ma-pa-ma-pa). Due to the omission of auxiliary words and case endings, the patient’s speech sometimes becomes “telegraphic.” With pronounced manifestations of this form of aphasia, it is possible for patients to form “speech emboli” - repetition of certain words (often swear words), which the patient pronounces “out of place,” while conveying his attitude to the situation through intonation. Sometimes the patient is able to repeat individual words after the examiner, but he cannot repeat a phrase, especially an unusual one, devoid of meaning. The nominative function of speech (naming objects), active reading and writing are impaired. At the same time, understanding of oral and written speech is relatively intact. Fragmentary automated speech and singing may be preserved (the patient can hum a melody).

Patients, as a rule, are aware of the presence of a speech disorder and sometimes have a hard time experiencing the presence of this defect, showing a tendency to depression. With Broca's efferent motor aphasia, there is usually hemiparesis on the side opposite the dominant hemisphere, while the severity of paresis is more significant in the hand and face (brachiofacial type).

Dynamic motor aphasia occurs with damage to the prefrontal region anterior to Broca's areas and is characterized by a decrease in speech activity and initiative. At the same time, reproductive (repetition of words and phrases after examination) and automated speech suffer significantly less. The patient is able to articulate all sounds and pronounce words, but his motivation to speak is reduced. This is especially clear in spontaneous narrative speech. Patients seem to be reluctant to enter into verbal contact; their speech is simplified, reduced, and exhausted due to the difficulty of maintaining a sufficient level of mental activity in the process of verbal communication. Activation of speech in such cases is possible through a stimulating effect on the patient, in particular a conversation on a topic that has a high degree of personal significance for the patient. This form of speech loss can be explained as a consequence of a decrease in the influence on cortical structures from the activating systems of the reticular formation of the oral parts of the brain stem.

Sensory aphasia, or acoustic-gnostic aphasia, occurs when Wernicke's area, located in the posterior part of the superior temporal gyrus, is damaged. Sensory aphasia is based on a disorder of speech recognition in the general sound stream due to a violation of phonemic hearing (phonemes are units of language with the help of which its components are distinguished and equated; in Russian speech these include voiced and deaf, stressed and unstressed). In this case, there is a violation of sound-letter analysis and alienation of the meaning of words.

With sensory aphasia, the ability to repeat words is also lost. A patient with sudden loss of speech in the form of sensory aphasia cannot correctly name familiar objects. Along with the impairment of the patient’s oral speech, the ability to understand written speech and read is also impaired. Due to a phonemic hearing disorder, a patient with sensory aphasia makes mistakes when writing, especially when writing from dictation. In this case, first of all, letter substitutions are characteristic, reflecting stressed and unstressed, hard and soft sounds. As a result, the patient’s own written speech, like oral speech, seems meaningless, but the handwriting may remain unchanged.

In typical, isolated sensory aphasia, manifestations of hemiparesis on the side opposite the dominant hemisphere may be absent or mild. However, superior quadrant hemianopsia is possible due to the involvement of the lower part of the optic radiation in the pathological process passing through the temporal lobe of the brain.

Semantic aphasia occurs when the inferior parietal lobule is damaged. It is manifested by difficulties in understanding phrases that are somewhat complex in construction, comparisons, reflexive and attributive logical-grammatical phrases expressing spatial relationships. The patient is not oriented in the semantic meaning of prepositions and adverbs: under, above, before, behind, above, below, lighter, darker, etc. It is difficult for him to understand the difference between the phrases: “The Sun is illuminated by the Earth” and “The Earth is illuminated by the Sun,” “Father’s brother” and “Brother’s father”, give the correct answer to the question: “If Vanya follows Petya, then who goes ahead?”, draw a triangle in a circle, a cross over a square, etc. according to the instructions.

Amnestic (anomic) aphasia is observed when the posterior parts of the parietal and temporal lobes of the left hemisphere, mainly the angular gyrus, are damaged, and is manifested by the inability to name objects; in this case, the patient can correctly speak about their purpose (for example, when the examiner asks to name the pencil being shown, the patient states: “Well, this is what they write with” and usually tries to show how it is done). The hint helps him remember the right word for the name of the object, and he can repeat this word. The speech of a patient with amnestic aphasia has few nouns and many verbs. At the same time, active speech is fluent, understanding of both oral and written speech is preserved. Concomitant hemiparesis on the side of the subdominant hemisphere is uncommon.

Total aphasia is a combination of motor and sensory aphasia: the patient does not understand speech addressed to him and at the same time he himself is unable to actively pronounce words and phrases. It develops more often with extensive cerebral infarctions in the basin of the left middle cerebral artery and is usually combined with severe hemiparesis on the side of the hemisphere opposite to the dominant one.

It was proposed to take into account the often clinically encountered manifestations of minimal dysphasia, or preaphasia, in which a speech defect manifests itself so easily that during a normal conversation it can go unnoticed by both the speaker and his interlocutor. Preaphasia is possible both with increasing brain pathology (atherosclerotic encephalopathy, brain tumor, etc.), and in the process of restoration of impaired functions after a stroke, brain injury, etc. (residual dysphasia). Its identification requires particularly careful research. It can manifest itself in the form of speech inertia, spontaneity, impulsiveness, decreased ability to quickly and easily select the right words, and the use of predominantly words that appear in the patient’s dictionary with great frequency. At the same time, rarer words are recalled with difficulty and with delay, and the patient often replaces them with more frequently occurring, although less appropriate words in the given context. In the speech of patients, “clichéd” words and phrases, speech “cliches,” and habitual speech patterns become abundant. Not finding the exact words and phrases in a timely manner, the patient tends to substitute words (“well, this thing, what’s it like”) and thus compensate for the lack of quality of his speech with an excessive amount of speech production, and therefore excessive verbosity manifests itself. If the patient performs individual tasks correctly, then performing a serial task (for example, touching the bridge of the nose with the index finger of the right hand, holding oneself by the right ear with the left hand and closing the left eye) is difficult. Verbally presented material to patients is poorly interpreted and inaccurately repeated; difficulties arise in explaining the meaning of such generally accepted expressions and proverbs as “golden hands”, “take the bull by the horns”, “there are devils in still waters”, etc. Difficulties may occur when listing objects belonging to a certain class (animals, flowers, etc.). Speech disorders are often identified when the patient compiles an oral or written story based on a picture or on a given topic. In addition to other difficulties, in the process of communicating with a patient, uncertainty in the perception of a verbal task and the resulting slowness of reactions to it may be noted.

THE SECOND MANDATORY STEP IS TO FIND OUT THE MAIN CAUSE OF THE SUDDEN LOSS OF SPEECH:

2. Stroke in the left half of the brain

3. Condition after a seizure

4. Migraine with aura in the form of speech impairment

5. Encephalitis caused by herpes simplex virus

6. Thrombosis of the intracerebral sagittal sinus

7. Psychotic mutism

8. Psychological problems

Diagnostic tests performed to diagnose the causes of sudden loss of speech:

Complete blood count and erythrocyte sedimentation rate (ESR); blood chemistry; computed tomography CT or magnetic resonance imaging (MRI); ophthalmologist

fundus, visual fields; examination of cerebrospinal fluid (CSF);

Doppler ultrasound (USDG) of the main arteries of the head; consultation with a neuropsychologist.

1 Cause of sudden loss of speech - Brain tumor or abscess.

Sudden loss of speech can occur: due to a rupture of a vessel supplying the tumor with blood, which is accompanied by hemorrhage into the tumor;

due to the rapid increase in swelling;

or - in the case of a left-hemispheric tumor or abscess - due to a partial or widespread seizure of epilepsy.

With computed tomography, both for a tumor and for an abscess, a space-occupying process inside the brain is diagnosed in the form of a low-density focus with or without contrast uptake. With abscesses, there is often more pronounced perifocal edema, i.e. located or occurring near the site of tissue damage. The cause of sudden loss of speech is Migraine with aura.

2 The cause of sudden loss of speech is a stroke in the left hemisphere of the brain.

When speech impairment occurs in an elderly patient, the most likely diagnosis is a stroke. In most cases, speech impairment during a stroke is detected in the patient

lack of strength or muscle weakness in the right arm and/or leg, impaired sensitivity in the right arm and/or leg, and sometimes impairment in the right field of vision.

Computed tomography and magnetic resonance imaging are the only things that most reliably distinguish intracerebral hemorrhage from ischemic stroke.

Loss of speech almost always occurs with a left-hemisphere stroke. It can also be observed with a right hemisphere stroke (i.e., with damage to the hemisphere opposite to the dominant one), but in these cases speech is restored much faster.

3 The cause of sudden loss of speech is a condition after a convulsive seizure.

At any age, acute sudden loss of speech can be caused by a condition following a seizure.

In these cases, speech is quickly restored.

The epileptic seizure itself may go unnoticed, and the bite of the tongue or lips may be absent;

EEG helps to diagnose the condition after a convulsive seizure as the cause of loss: generalized or local slow and sharp wave activity is recorded.

An increase in the level of creatine phosphokinase in the blood is unreliable as a diagnosis of an epileptic seizure.

4 In young patients, sudden loss of speech may be caused by migraine with aura.

In 60% of cases, during the collection of a medical history, the patient’s relatives also have migraine headaches.

In these cases, acute or subacute speech loss occurs simultaneously with the headache.

On ELECTROENCEPHALOGRAPHY - EEG, there may be a focus of slow-wave activity in the left temporo-parietal region, which can persist for 3 weeks, while

Magnetic resonance imaging and computed tomography do not find any causes. Pronounced focal changes in the EEG in the absence of abnormalities according to the results of neuroimaging

Studies on the 2nd day of the disease, in principle, make it possible to make the correct diagnosis, with the exception of the cases of herpetic encephalitis described below.

If possible, transcranial Doppler ultrasound should be performed. In a patient suffering from migraine and related

to the age group from 40 to 50 years, there may be asymptomatic stenotic vascular lesions, but the typical nature of the headache, rapid reverse

development of symptoms and absence of structural changes in the brain according to the results of neuroimaging research methods in combination with the changes described above in

EEG allows you to make the correct diagnosis.

The patient should not have cardiac murmurs, which may indicate the possibility of cardiogenic embolism, which can occur at any age.

A possible source of embolism is identified (or excluded) using echocardiography. Listening to vascular murmurs over the vessels of the neck is less reliable compared to

5 The cause of sudden loss of speech is encephalitis caused by the herpes simplex virus.

Because with herpetic encephalitis caused by the herpes simplex virus

The temporal lobe is predominantly affected, with aphasia (or paraphasia) often occurring first

With computed tomography and magnetic resonance imaging, a zone of low density is identified, which soon acquires the characteristics of a volumetric process and spreads from the deep parts of the temporal lobe to the frontal lobe, and then contralaterally, primarily involving areas related to the limbic system. In the cerebrospinal fluid

there are changes in the inflammatory process.

The EEG reveals focal slow-wave activity, which, with repeated EEG recording, changes into periodically occurring three-phase complexes. Over time, these complexes also capture the frontal and leads on the opposite side. Clarification of the herpes simplex virus by direct visualization of viral particles or using immunofluorescence analysis is carried out with a significant time

delay, while antiviral therapy should begin immediately when the first suspicion of viral encephalitis arises (taking into account that the mortality rate for encephalitis caused by the herpes simplex virus

6 The cause of sudden loss of speech is thrombosis of the intracerebral sagittal sinus.

A triad of symptoms that may indicate thrombosis of the intracerebral sinus: general or partial epileptic seizures, hemispheric focal symptoms, decreased level of wakefulness.

With magnetic resonance imaging and computed tomography, sinus thrombosis is indicated by swelling of the hemisphere (mainly in the parasagittal region) with diapedetic hemorrhages,

signal hyperintensity in the area of ​​the sinus(es) and a deltoid-shaped area that does not accumulate the injected contrast and corresponds to the affected sinus.

The EEG records generalized low-amplitude slow-wave activity over the entire hemisphere, also extending to the opposite hemisphere.

7 Cause of sudden loss of speech - psychotic mutism

negativism in schizophrenia.

8 The cause of sudden loss of speech is psychogenic mutism.

Psychogenic mutism is manifested by the absence of responsive and spontaneous speech while maintaining the ability to speak and understand speech addressed to the patient. This syndrome may

observed in the picture of conversion disorders. Another form of neurotic mutism in children is selective, which occurs when communicating with only one

Lethargy is a symptom of certain diseases, usually of the central nervous system and brain, or a consequence of severe psycho-emotional shock. This state of a person is characterized by the fact that he has a decrease in the speed of reaction to actions addressed to him or performed by himself, a deterioration in concentration, more extended, with long pauses in speech. In more complex cases, there may be a complete lack of reaction to surrounding events.

This human condition should not be confused with a chronic depressive state, since the latter is more of a psychological factor than a physiological one.

The true causes of lethargy can only be determined by a qualified doctor. It is strongly not recommended to carry out treatment at your own discretion or ignore such a symptom, as this can lead to serious complications, including irreversible pathological processes.

Etiology

Retardation of movements and thinking in a person can be observed in the following pathological processes:

• head injuries;
• malignant or benign formations in the brain;
• diseases that affect the central nervous system;
• mental disorders;

In addition, a temporary state of slowness of reaction, movement and speech can be observed in the following cases:

• under alcohol or drug intoxication;
• with and constant lack of sleep;
• with frequent nervous overstrain, chronic;
• under circumstances that cause a person to feel fear, anxiety and panic;
• with severe emotional shock.

Psychomotor retardation in a child may be due to the following etiological factors:

• vascular diseases of the brain;
• stressful situations;
• psychological disorders.

Depending on the underlying factor, this condition in a child can be temporary or chronic. It goes without saying that if such a symptom appears in children, you should immediately consult a doctor, since the cause of the pathology can be dangerous to the baby’s health.

Classification

The following types of retardation are distinguished according to the clinical picture:

• bradypsychia - inhibition of thinking;
• mental or ideational inhibition;
• motor or movement retardation;
• emotional inhibition.

Establishing the nature of this pathological process lies within the competence of only a qualified physician.

Symptoms

The nature of the clinical picture, in this case, will entirely depend on the underlying factor.

When the brain and central nervous system are damaged, the following clinical picture may be present:

• (hypersomnia), lethargy;
• , which will intensify as the pathological process worsens. In more complex cases, pain relief is impossible even with painkillers;
• memory impairment;
• decreased quality of cognitive abilities;
• the patient cannot concentrate on performing usual actions. What is noteworthy is that it is the professional skills that are retained;
• sudden mood swings, traits appear in the patient’s behavior that were not previously characteristic of him, most often attacks of aggression are observed;
• illogical perception of speech or actions addressed to him;
• speech becomes slow, the patient may have difficulty finding words;
• and, which is most often observed in the morning;
• unstable blood pressure;

In a child, the general clinical picture with this kind of pathology may be complemented by moodiness, constant crying or, on the contrary, constant drowsiness and apathy for usual favorite activities.

It should be noted that the symptoms described above are also observed after. If you suspect that a person is having a seizure, you should call emergency medical attention and rush them to hospital. It is the urgency and coherence of primary medical measures after a stroke that largely determine whether a person will survive or not.

If the cause of a delayed reaction in an adult is a mental disorder, the following symptoms may be present:

• or drowsiness, which is replaced by an apathetic state;
• unreasonable attacks of aggression;
• sudden change in mood;
• causeless attacks of fear, panic;
• suicidal mood, in some cases, actions in this direction;
• state of chronic depression;
• visual or auditory hallucinations;
• nonsense, illogical judgments;
• neglect of personal hygiene, sloppy appearance. At the same time, a person can be firmly confident that everything is fine with him;
• excessive suspicion, the feeling that he is being watched;
• deterioration or complete loss of memory;
• incoherent speech, inability to express one’s point of view or specifically answer simple questions;
• loss of temporal and spatial orientation;
• feeling of constant fatigue.

You need to understand that this human condition can progress quickly. Even if the patient’s condition improves temporarily, it cannot be said that the disease has been completely eliminated. In addition, such a person’s condition is extremely dangerous both for him and for the people around him. Therefore, treatment under the guidance of a specialized doctor and in an appropriate institution is, in some cases, mandatory.

Diagnostics

First of all, a physical examination of the patient is carried out. In most cases, this should be done with a person close to the patient, since due to his condition he is unlikely to be able to answer the doctor’s questions correctly.

In this case, you may need to consult the following specialists:

• If the cause of such a person’s condition is either the central nervous system, then an operation is performed to excise it, followed by drug treatment and rehabilitation. The patient will also need rehabilitation after a stroke.

  Drug therapy may include the following drugs:

  • painkillers;
  • sedatives;
  • antibiotics if the disease is of an infectious nature;
  • nootropic;
  • antidepressants;
  • tranquilizers;
  • drugs that restore glucose levels;
  • vitamin and mineral complex, which is selected individually.

  In addition, after completing the main course of treatment, the patient may be recommended to undergo a rehabilitation course in a specialized sanatorium.

  Provided that therapeutic measures are started in a timely and correct manner and are fully implemented, almost complete recovery is possible even after serious illnesses - oncology, stroke, psychiatric illnesses.

  Prevention

  Unfortunately, there are no specific prevention methods. You should follow a rest and work schedule, protect yourself from nervous experiences and stress, and begin treatment for all diseases in a timely manner.