Global aphasia: symptoms, causes and treatment

The most severe type of aphasia, in which the patient is unable to speak or understand.

Imagine waking up one morning, or after an accident, and suddenly finding that everyone starts speaking in a strange language. suddenly find that everyone starts speaking in a strange language.. The worst thing is that it sounds familiar, but we do not understand what they want to tell us.

We try to communicate, but we realize that we are not saying what we mean. The others insist, look at us and keep talking to us even though we do not understand what they are trying to communicate. And we also fail to make ourselves understood. Although it may sound like a science fiction movie, this is what people suffering from global aphasia experience..

The concept of aphasia

Aphasia is a group of speech and language disorders caused by a brain injury.which occur in adults with a language that had already been previously consolidated.

• Recommended article: "Aphasia: the main language disorders".

This type of disorders can affect very different aspects of language, among which we can find verbal fluency, articulation ability, language comprehension, repetition, grammar, literacy or naming. The different aspects affected will depend on the lesioned area.

Broadly speaking, one of the main classifications of these disorders is the one proposed by Goodglas and Kaplan, in which they are divided into different typologies depending on whether or not they present a good level of verbal fluency, comprehension and repetition capacity. The best known are Broca's aphasia and Wernicke's aphasia, each with its own impaired and preserved aspects. However, There is a type of aphasia in which there are alterations in all areas of language, known as global aphasia..

Global aphasia: main features

Global aphasia is the most severe form of aphasia.Because all or most of the different aspects of language are affected and altered by a brain lesion.

People who suffer from it have severe difficulties both in comprehension and in oral and generally also written expression. Similarly, subjects affected by global aphasia have poor imitation skills. If they are able to utter oral language, they often use a telegraphic and stereotyped area, with few possibilities of establishing communication by means of verbal language. They may also be able to understand certain words or verbs.

In addition, they tend to be unable to write or limit themselves to an automatism such as the ability to sign. Reading is also affected. It is possible that at the written level they can reproduce a text by copying it, although guided by the forms and not by its content. The capacity of articulation, verbal fluency and the use of lexicon and grammar are severely diminished and impaired..

Because the lesion causing global aphasia is massive, other symptoms such as ideomotor apraxia (inability to use objects for their true purpose) and ideational apraxia (inability to follow sequences of action in the correct order), hemiplegia or half-body paralysis are often present. Global aphasia per se does not cause any cognitive difficulties, and intelligence and most executive functions are preserved. However, it is possible that they may present cognitive and intellectual difficulties due to neuronal damage, limiting them even more.

Causes

The causes of aphasia, as mentioned above, are due to the presence of lesions in the areas that control language, are due to the presence of lesions in the areas that control the languageThe causes of aphasia, as we have mentioned above, are due to lesions in the areas that control language, their connections with each other or the connections with other brain nuclei that allow linguistic information to be integrated with motor information, or that have been destroyed.

In the case of global aphasia, there must be significant damage in the left hemisphere as a whole, where the areas that process language are located, or in the area surrounding the perisylvian cortex. Both Broca's and Wernicke's areas are damaged or disconnected from the rest of the brain, their connections with each other or the connections with other areas that allow the processing or execution of speech.

What exactly causes these lesions can vary greatly, ranging from head trauma or lacerations to strokes, brain tumors or neurodegenerative diseases.

Difficulties caused by this disorder

The consequences of global aphasia and the symptoms it causes are very limiting for the person who suffers from it.. As social beings, our life is structured on the assumption that we are able to communicate. That is why not being able to express oneself can lead to

At the social level, global aphasia greatly hinders the possibility of establishing affective relationships with our peers. Although his social skills and interest in establishing contact with others are preserved, the patient has severe difficulties in making himself understood unless alternative methods are available. It is common that, given that before the injury he could communicate orally correctly, the environment tries to communicate by shouting (interpreting that he has lost hearing ability) or interprets the lack of communication on the part of the subject as lack of interest. It is important to understand that the subject hears perfectly, being his difficulty to interpret the language.

This problem also generates difficulties at work, as well as academically. Learning, at least by the usual means, is complicated unless adapted strategies such as the use of pictograms or physical procedures are employed.

At the level of the individual, this disorder can be experienced with real dread.. After all, the subject is suddenly unable to understand what they are trying to say or to make themselves understood through the usual mechanisms, and unsuccessful attempts by the subject and the environment to re-establish oral communication can end up causing high anxiety and depression for the individual. The subject may feel isolated, withdrawn into himself, until treatment begins to be effective or alternative forms of communication are found.

Possible treatments

The treatment to be used in case of global aphasia is focused on the recovery of the functions altered by the brain lesion and/or the adoption or learning of alternative methods of communication. Psychological and social support is also essential to enable the patient and his or her environment to understand and accompany the patient in the process he or she is undergoing.

It is important to bear in mind that many brain injuries can evolve in such a way as to reduce damage. This is what happens, for example, in the case of trauma or stroke, where the Blood may choke part of the brain connections but leave an ischemic twilight zone that may recover from the accident. In this way, many patients may see the effects of the injury progressively diminish. In some cases this may result in a shift from a global aphasia to a more localized aphasia.

The use of speech therapy and speech therapy is common, being used to improve and optimize the linguistic competence that the affected person may maintain. It is also frequent the use of augmentative language techniques, or the use of visual material such as pictograms with which the patient can communicate in an alternative way.

It is important to stimulate the patient without overloading him/her, so that he/she can gradually relearn and polish skills without becoming saturated. and polishing skills without becoming saturated. Psychoeducation is very important for both the patient and the environment, since it is necessary to make the patient understand that cognitive skills are preserved (unless there are other affectations beyond global aphasia) and the difficulties that aphasia entails for the subject.