Sunday, May 8, 2016

EXPRESSIVE APHASIA

   I have always wondered about the speech or the language.  when different people speak English they speak in different way or have different accent. I think that the accent is based on the person's mother tongue.. (Is it called mother tongue as the father does not get a chance to speak?)So when a Hispanic speaks English it is different that when I Frenchman speaks. I for that matter can distinguish different accents of people from India . This is how the CHINAYA SUZUKI thought about the music. He felt that the music was a language and as we don't have to teach a child a language or it's peculiar accent , we don't have to teach a child a music if he or she can hear it frequently. But I am not talking about this part of the language , or the speech . I am talking about the origin of speech .
    The other day I saw this patient with respiratory failure . She had been a smoker and had rheumatoid arthritis . She came to hospital with shortness of the breath and then needed significant oxygen .When I saw her in ER , she was mildly short of breath and was talking OK. She may have had pneumonia , but when I saw her old X-ray , I knew that she had fibrosis , or scar tissue in lungs , probably from her rheumatoid arthritis. So I knew that we are going to have some tough time in weaning her oxygen . But she did OK , did get little better. But then the hospital doctor called me one morning telling me that she was confused and he did not have idea as to the reason for it . So when I saw her and examined her I was surprised . She was NOT CONFUSED ,but had Expressive Aphasia. SHE COULD NOT EXPRESS . She could move her all extremities. But when I showed her a pen , she could not name it and was saying yes to every question. So I knew that she most likely had stroke . I ordered a CT scan of the brain and asked a neurologist to look at her . CT scan of the brain showed abnormal area in the frontal lobe . The neurologist had no specific diagnosis.
     The speech is formed as a result of coordination of various areas in the brain. Broka's area and the Wernikoff's area are the 2 known area and the frontal lobe stroke most likely caused the aphasia .When we see something, we know what it is and the word is formed . When we listen to a sound we know what it means and when we touch , we know what we feel .
  For those who are interested in Hindu Religion , there are 4 different speeches , They are called PARA. PASHYNTI MADHYAMA AND VIKHARI. The last one is spoken speech . May some day I will try to explain what the other 3 mean .

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