As a result of an acute circulatory disorder, the patient experiences damage to different areas of the brain. In accordance with the volume and damaged structure, problems with the functioning of the body develop. In most cases, the speech center is affected, which is accompanied by complete or partial loss of speech after a stroke. Such consequences are possible with different types of stroke: hemorrhagic, when the brain receives excess blood, and ischemic, when there is insufficient blood supply.
Stroke ranks third in mortality worldwide. In 25% of clinical cases, patients develop disability, more than 60% become disabled. Deterioration of articulation is the main sign by which a vascular rupture can be detected. If a person has had a stroke, there is a high probability of the following consequences:
- confusion in words (arrangement in a chaotic order);
- difficulty pronouncing certain sounds clearly;
- difficulty in remembering the names of some objects;
- difficulty in understanding speech addressed to him;
- loss of the ability to express one's thoughts.
Speech impairment persists for a long time, but can be corrected through special exercises and drug therapy. Let's take a closer look at how to restore speech after a stroke.
Signs and reasons why speech function is impaired
Aphasia is a speech disorder that is diagnosed in a patient if he cannot pronounce words clearly, has difficulty reading or understanding spoken speech. Such signs appear against the background of a disturbance in the nutrition of neurons.
Depending on the severity of the lesion, after diagnosis, it is possible to predict how quickly a person’s speech function will normalize. The speed of speech restoration depends on a number of criteria, including: the area of the lesion, the support of loved ones, the speed of treatment, and the quality of rehabilitation.
Patients and their relatives often wonder whether speech will be restored after a stroke on the left side. The approach to therapy must be comprehensive. Several specialists take part in drawing up a treatment plan: neurologists, speech therapists and rehabilitation specialists. An individual plan is developed for each patient, which has a positive effect on the dynamics of recovery after a stroke.
How to restore speech function, what to do at home to develop it?
When the rehabilitation process continues at home, the most important thing for the patient is the support of relatives and a gradual return to normal activities, which may be difficult at first.
Speech therapy exercises for the patient
- Make a circular motion with your tongue, running it along the front surfaces of your upper and lower teeth. Repeat 5-10 circles clockwise and then counterclockwise.
- Click your tongue so that the sound resembles the clopping of hooves. Such clicks need to be repeated from 10 to 20 in one approach. During the day there can be up to 5 such approaches.
- Curl your tongue into a tube and try to stick it out of your mouth as far as possible. Repeat this movement 5-10 times.
- Smile, feeling the tension in your facial muscles. In this case, the teeth should be closed and the lips slightly unclenched. Repeat 7-10 times. Then close your lips and smile 5-7 times.
- Perform air kisses by loudly smacking your lips. Repeat 10-15 times.
Important! The patient should try to repeat as many exercises as possible at one time. If you feel tired, it is better to take a break.
Practical exercises for doing it yourself at home
Here's what to do if a patient has poor speech function, how you can “talk” him:
- Reading simple books or magazines for 5-10 minutes a day.
- The patient must make a verbal description of the object or his day within 10-15 minutes.
- Reading tongue twisters at a slow pace for 10-15 minutes (you need to move on to this stage when the patient learns to pronounce entire phrases without problems).
The course of rehabilitation is individual for each person , so you should ask a speech therapist for recommendations before moving on to specific home activities.
What are the types of speech disorders in stroke?
When a blood vessel ruptures in the brain, speech functions are first affected. With hemorrhage, various disorders appear (difficulty in understanding one’s own speech, inability to form words). In addition to aphasia, there are other types of disorders - dysarthria and dyspraxia.
Features of aphasia
It is characterized by deterioration of speech functions against the background of damage to speech centers in the brain. It is divided into complete (when there is no speech at all) and partial. Also, there are 6 forms, including:
- Motor. It can be afferent and efferent. With afferent, a person has difficulty maintaining an articulatory posture. Many people lack instinctive speech. With efferent, difficulties arise with the assimilation and reproduction of the motor program. Speech is characterized by rearrangement of sounds and syllables.
- Sensory. With this form, Wernicke's center, localized in the temporal lobe, is affected. As a result, a person loses the ability to understand speech, but conversational function is preserved. Sometimes visual function deteriorates.
- Dynamic. It is characterized by difficulty or complete absence of the possibility of active expression. The person is unable to pronounce long sentences and has great difficulty constructing phrases. During a conversation, speech patterns dominate.
- Acoustic-mnestic. The main clinical manifestation is difficulty retaining recently acquired information in memory. There are patients who cannot repeat a phrase of several words after a speech therapist. It is difficult for them to name the objects around them, because they simply do not remember their names.
- Semantic. Patients do not perceive complex speech formulations. Many people have difficulty solving problems that contain complex syntactic structures. Patients with this form read very slowly.
- Total. This is the most severe form, which is characterized by a complete absence of speech (due to damage to many speech areas of the brain). Most patients do not even recognize their closest relatives. This form requires a long recovery.
Features of dysarthria
With dysarthria, the mobility of the speech organs is limited, which makes articulation difficult. As a rule, in adults the disease does not lead to the collapse of the speech system. It is often accompanied by problems with swallowing and breathing. In more than 70% of cases, it occurs as a result of a stroke. The main signs of dysarthria include:
- difficulties in the mobility of articulation organs;
- disturbances in fluency of speech (constant hesitation);
- unintelligible and slurred speech;
- problems with speech rate (slow or accelerated);
- monotony of intonation (monotonous speech);
- grimaces;
- changes in voice timbre.
There are several forms of dysarthria: bulbar, pseudobulbar, cerebellar, subcortical and cortical. Each of them is associated with a specific location of brain damage. To restore speech, the help of a speech therapist is required. He conducts diagnostics to identify which aspects of speech are impaired and draws up an individual therapy program.
Features of articulatory dyspraxia
Articulatory dyspraxia is a disorder in which the facial muscles maintain the normal tone of the body, but the movements and coordination required to produce sounds are impaired (pronunciation is slurred). There are problems remembering the next movement in a sequence, which causes a lot of inconvenience in everyday life.
People with dyspraxia may speak continuously and repetitively. Ensuring content and consistency in language is often very difficult. Speech is often unclear and tempo and tone cannot be fully controlled. For treatment, an integrated approach is used.
Location of speech centers in the brain
The brain is the most significant organ of the human central nervous system. The nuclei located in the brain stem send impulses to certain areas that carry out motor commands. Among them are the nerves that are involved in the creation of speech.
The location of speech zones is determined by the dominant hemisphere. In people who control predominantly the right hand, the centers are located in the left hemisphere. For left-handers - in the right.
In the lower part of the frontal lobe is Broca's center, which is involved in the process of speech production. This part of the brain is responsible for the articulatory process of speech and contracts the muscles of speech-producing organs.
Broca's and Wernicke's center in the brain
Broca's area also covers the process of constructing sentences, correct word order, and sequence of statements. If the functioning of this zone is disrupted, a person ceases to clearly express his thoughts. The ability to understand speech is preserved.
Wernicke's area is located in the posterior region of the temporal gyrus and is responsible for comprehending oral and written speech. It is an auditory center capable of analyzing and comparing what is heard. There are other auxiliary speech centers, which are located in different parts of the cerebral cortex. They are responsible for logical thinking, the ability to isolate the main idea of a text, read, and identify sounds.
People who have had a stroke may have two types of speech disorders.
Stroke is a disease that can appear for no apparent reason. How long do they stay in the hospital with a stroke - stages and treatment depending on the severity of the disease.
Read about the treatment of ischemic stroke with medications here.
Hemorrhagic stroke is an insidious disease that can be fatal. Here https://neuro-logia.ru/zabolevaniya/insult/gemorragicheskij/posledstviya-2.html detailed information about the possible consequences of a stroke.
Occurs when subcortical structures of the brain are damaged.
This is a violation of the pronunciation of words, caused by dysfunction of articulation, phonemic structure, speech breathing, and intonation.
As a result, a person’s speech becomes unintelligible.
There is increased salivation, slow pronunciation, and weakened articulation. The facial muscles become less mobile, resulting in distortion of spoken sounds. At the same time, the patient understands speech and is able to write and read.
There are four types of dysarthria:
- mild degree of the disease, in which signs of dysarthria are detected only by a specialist;
- speech is understandable to others, but there are defects in pronunciation;
- speech is illegible, understandable only to a narrow circle of people;
- severe dysarthria, characterized by a lack of spoken language.
The disease is characterized by complete or partial impairment of speech activity while maintaining hearing and articulation. The brain does not receive enough nerve impulse to express thoughts through the speech organs. Depending on the location of the lesion and the identified dysfunctions, aphasia is divided into several types:
Motor aphasia
It is observed when the upper parts of the main artery of the brain are damaged.
The main organs of speech retain their functionality, but the patient finds it difficult to control them.
With a mild form of motor aphasia, the ability to pronounce words and sentences is preserved.
In speech, there are changes in the sequence of presentation, a violation of the order of words and their forms. It is difficult for a person to pronounce some consonant sounds; he pronounces simple words syllable by syllable. At the same time, the meaning of what was said is clear.
More severe forms of motor aphasia are characterized by complete speech impairment after a stroke. The patient is unable to form words and can only pronounce vowel sounds. He understands other people's speech.
Treatment should begin one week after the stroke. To do this, it is enough to try to pronounce simple words and sing songs.
Sensory aphasia
The disease occurs due to damage to Wernicke's area. Characterized by complete or partial loss of speech understanding. Hearing function is preserved.
The patient is able to reproduce fragments of words, individual sounds that have no semantic connection with each other. There are problems with reading, writing and counting.
The patient enters a state of excitement and actively gestures with his hands. Can follow directions (open mouth, turn head, sit down). Able to repeat simple words, but does not find meaning in them. In speech addressed to him, he hears incoherent sounds. The ability to read and write is lost.
When the parietal region of the left hemisphere is damaged, disorientation in space is observed.
Sensory aphasia can manifest itself in a mild form, then a person recognizes everyday words and phrases. The difficulty of treatment lies in the lack of understanding of speech.
Dynamic aphasia
It occurs due to damage to the posterior frontal areas of the dominant hemisphere.
Characterized by the lack of wording of the text.
The patient cannot mentally construct a sentence and reproduce it orally. The thought process is distorted.
A person confuses the forms of words, uses simple sentences, template phrases, and swaps sounds.
Dynamic aphasia is characterized by spontaneous utterances. The structure of the text and semantic integrity are violated, only fragments of phrases are spoken. The patient forgets words, tries to find a synonym, or explain what he wants in other ways.
With a mild form of the disease, a person is able to understand slowly spoken speech. But when the pace of conversation accelerates, the patient loses the meaning of the statement. When answering a question, he uses the same words that the interlocutor said.
Read also: Extensive stroke of the right hemisphere
A more complex form of dynamic aphasia puts the patient in an inert state . There are difficulties in understanding long sentences. Speech may be completely absent. The patient shows no interest in what is happening around him.
To restore the sequence of thinking, the speech therapist suggests describing interconnected pictures and images. Together with the patient, various stories and dialogues are compiled, as a result of which the ability to plan speech returns.
Stroke is one of the most common causes of death in people worldwide. Signs of a stroke in a woman and methods of prevention are described in detail in the article.
We will tell you further how the recovery period goes for a patient after a stroke.
Acoustic-mnestic aphasia
Associated with disruption of the middle and posterior parts of the temporal part of the brain.
Characterized by a decrease in auditory-verbal memory. The ability to retain and process the required amount of information is lost.
The patient's understanding of the figurative meaning of words is distorted, and the meaning of the text is lost. Characterized by multiple repetitions of one word.
When communicating, the patient may forget the sound design of words and is able to explain using synonyms. Verbal paraphasias dominate in speech. For example, instead of the word “table,” a person says “chair” or “sofa.”
Reading and writing are partially preserved. Retelling text is difficult due to the inability to retain information in memory. Difficulties in counting arise when performing arithmetic tasks orally.
Amnestic aphasia
Deviation occurs when the lower part of the temporal region is affected.
It is considered the most “benign” type of aphasia. Characterized by awareness and adequacy of speech.
The patient retains intellectual, thinking, and auditory functions.
The main feature of Amnestic aphasia is the difficulty of choosing words when communicating. The patient forgets names and names of objects, but is able to describe them using adjectives and verbs.
Total aphasia
Appears immediately after an ischemic stroke.
The patient loses the ability to reproduce and understand speech, while auditory function does not change.
Sensitivity decreases. A person ceases to recognize written and oral speech, gestures, articulation, and sounds. The ability to pronounce individual sounds, cough, and moo is preserved.
With more serious focal lesions, the patient's right arm is paralyzed. General behavior is passive.
Total aphasia can develop into more complex forms, so treatment begins immediately after abnormalities are identified.
Damage to any part of the brain can adversely affect the functioning of the central nervous system.
A person who has suffered a stroke needs the attention and care of loved ones. Try to be patient with the patient. Surround him with positive emotions, and the healing process will noticeably speed up.
Basic methods of speech restoration
As a result of an acute circulatory disorder, a person learns to communicate again. This is a labor-intensive and long process. During the rehabilitation period, coordinated work between doctors and the patient’s family is important. In order for him to recover faster, his close relatives should be patient and follow the following rules:
- Do not forget to let your loved one know that he is dear and important.
- Support the person as much as possible, show full confidence in a speedy recovery, and celebrate his progress.
- Talk regularly, tell all the latest news.
During treatment, your support and participation is very important to the patient. You can listen to his favorite music, watch movies, read books with him.
Let's take a closer look at the main methods of restoring speech function.
Training with a speech therapist
A speech therapist plays a major role in the rehabilitation process. He conducts tests, assesses the patient's condition and performs appropriate exercises with him. A specialist is present at every session, helps the patient and monitors the correctness of the technique. In the future, constant supervision by a speech therapist is not required; the patient can train independently. It is important to adhere to the following rules:
- complete tasks gradually, starting with simple ones and moving on to more complex ones;
- be sure to avoid overwork (if the patient gets tired, the training will be over);
- maintain regularity of classes (the optimal frequency of classes is 5-7 times a week for half an hour).
The task of a speech therapist is to involve various areas of the brain in the process of speech control. Several complexes are used at once that are aimed at restoration:
- phonetic. They are required to improve facial control. During classes, individual sounds and words are repeated;
- visual. If sensory aphasia is diagnosed, then in classes they use cards with pictures and special aids that encourage finding sequences;
- semantic. They are required to stimulate active thinking. During classes, he is asked to continue the phrase he started or engage in an impromptu dialogue on a specific topic.
Massage
In addition to problems with speech, people who have experienced an acute circulatory disorder experience a number of other complications, in particular, sagging soft tissues (cheeks, corners of the mouth), impaired chewing function and excessive salivation.
Thanks to special massage sessions, it is possible to restore the tone of the facial muscles and significantly improve facial expressions. As a result, it will be much easier for the patient to pronounce words. Only a specialist can find the necessary points for massaging. He knows exactly which areas should be toned and which, on the contrary, should be relaxed.
In addition to facial massage, a person is prescribed a massage of the tongue, lips, cheeks, ears, scalp, and hands. Thanks to an integrated approach, it is possible to relieve muscle stiffness and improve speech.
Articulation exercises
Exercises that will be prescribed on an individual basis allow you to restore speech after a stroke. Their main task is to improve control over facial expressions, tongue and lips. Exercises to develop the muscles of the tongue may look like this:
- movement of the tongue in a circle;
- moving the tongue across the palate;
- tongue clicking;
- biting a relaxed tongue;
- sticking out the tongue, directing first to one corner of the mouth, then to the other;
- moving the tip of the tongue across the palate in different directions.
Lip exercises include smiling with your lips open, curling your lips, pulling them forward, puffing out your cheeks, and rolling air from one side to the other.
Exercises for correct and clear pronunciation include attempts to pronounce consonants alternately (first voiceless, then voiced), then vowels (with one sound flowing into another).
Exercises for facial expressions: include opening the mouth wide (hold for a few seconds and relax), raising, lowering and relaxing the eyebrows, folding the lips into a tube, stretching the tongue in different directions.
These exercises are not universal; the doctor develops a plan for each patient individually. There are many similar exercises. They should be performed in the presence of a speech therapist. To achieve positive results faster, it is recommended to perform the exercises regularly.
Abdominal breathing
Abdominal breathing (with the diaphragm) allows you to increase the volume of inhaled air and improve the saturation of cells with oxygen. As a result, heart function normalizes, blood pressure stabilizes, and anxiety goes away.
The breathing technique is carried out under the supervision of a specialist. There are many exercises, one of which could be this: in a comfortable horizontal position, take a deep breath through your nose, and then slowly exhale through your mouth. This exercise is repeated several times and then made a little more complicated. To do this, adding several sounds while exhaling:
- stretched [f];
- stretched [s];
- stretched [w];
- stretched [x].
The optimal number of repetitions is determined by a specialist.
Drug therapy
In addition to exercise, another important component of the rehabilitation period is drug therapy. Good cerebral circulation plays one of the key roles. A stroke significantly impairs the functioning of brain cells, so doctors prescribe medications that stimulate their functioning. Depending on the nature of the lesion, different groups of drugs are additionally prescribed to restore speech after a stroke. These include:
- Antihypertensive drugs (ACE inhibitors) to stop a strong jump in blood pressure.
- Antidepressants to combat chronic stress and bad mood.
- Nootropics to stimulate regeneration, improve memory, help restore the functioning of brain cells.
- Sedatives to relieve emotional stress and normalize sleep.
- Anticoagulants to reduce blood viscosity and prevent blood clots.
Medicines help to significantly reduce the severity of disorders, but they are not able to completely restore lost functions. A positive result will only come from an integrated approach to solving the problem (due to combination with other methods of therapy).
Stroke: the essence of pathology, types and causes of disorders
Stroke (English: “stroke” - blow) is a neurological pathology that is characterized by an acute disorder of cerebral circulation.
The blood supply to the structures of the central nervous system is carried out primarily through the internal carotid artery system and the formation of a vascular formation (Circle of Willis).
Depending on the mechanism of development of disorders, two variants of pathology are distinguished.
- Ischemic (from “ischaemia” - to stop bleeding) occurs due to an acute decrease in the transport of nutrients to the nervous tissue. Lack of oxygen and nutrient supply leads to degeneration of functional units, atrophy of nerve tissue and dysfunction.
- Hemorrhagic (from “haemorhagia” - bleeding). The pathology is characterized by a violation of the integrity of the vascular wall with the formation of an intracranial hematoma.
There is no specific reason that causes stroke in patients. Therapists, neurologists and cardiologists share a group of predisposing and triggering conditions.
- Risk factors include: age over 50 years, male gender, concomitant diseases of the cardiovascular system, hypertension, atherosclerosis, inadequate treatment of diabetes mellitus.
- Trigger factors: traumatic brain injuries, transient ischemic attacks (TIA) and major surgical interventions on the thoracic and abdominal organs.
In addition, predisposing factors include a family history (presence of stroke in relatives), smoking and stressful work. Treatment of all forms of cerebrovascular accident is carried out in a hospital setting.
Speech disorders after stroke
The consequence of acute cerebrovascular accident is focal symptoms depending on the affected area. Characteristic symptoms of a stroke:
- Asymmetry of facial muscles caused by central facial palsy.
- Unilateral muscle paralysis is the inability of volitional contraction and movement. In one of the early diagnostic tests, the patient is asked to raise his hand or stick out his tongue. The absence of movements while the patient is clearly conscious and attempting to fulfill the request indicates paralysis.
- Anisocoria – the pupils in both eyes are of different diameters.
- Incoherent or absent speech is associated with impaired innervation of the articulatory apparatus. Speech impairment after a stroke occurs due to damage to the middle cerebral artery of the dominant hemisphere.
Read also: Case history of stroke
Important! In most people (right-handed), the speech center is located in the left hemisphere, so speech disorders occur with a left-sided stroke.
After suffering a circulatory disorder in the brain, sensory (perception) and productive (reproduction) forms of written and oral speech are damaged.
In the classification of written speech disorders, the following options are distinguished:
- Violation of productive synthesis - writing (dysgraphia). The pathology is characterized by impaired formation of the spatial image of a symbol, frequent agrammatisms (errors) in the spelling of elementary words. The most severe degree of the disorder is called agraphia and is characterized by a complete loss of writing skills.
- Perception-reading disorder (dyslexia). This disorder is characterized by the loss of the ability to recognize letters, combine syllables and words with preserved intellectual abilities and visual acuity. Complete loss of reading skills - alexia.
For oral speech, the variants of disorders vary, depending on the location of the affected area and the clinical manifestations of circulatory disorders.
- Semantic-structural – characterized by a violation of the grammatical design of speech with errors in the use of phrases and coordination of parts of a complex sentence.
- An isolated phonemic disorder, which is associated with damage to articulation while maintaining the skills of structural speech.
Clinical characteristics of oral speech disorders
Impaired oral communication is one of the most traumatic factors for a stroke patient. There are two types of violations:
- Dysarthria (from “dys” - disorder, “art” - pronunciation) is a pathology that occurs as a result of damage to the innervation of the articulatory apparatus. It is characterized by an imbalance in the contraction of the vocal cords, tongue and lips.
Clinical symptoms of the disorder: unclear speech that is incomprehensible to others, sound mixing, distortion of words, lack of differentiation of sounds of individual groups.
Treatment of this form is considered the most effective.
- Aphasia is a disorder characterized by the absence of speech in a person with normal hearing and intelligence against the background of already formed oral communication skills. There are three types of aphasia: motor, sensory and semantic.
The motor form occurs due to damage to the lower part of the frontal lobe of the dominant hemisphere (Broca's area), which is responsible for contracting the speech muscles of the larynx, pharynx and tongue. People with this pathology understand well the spoken language of others, but are unable to pronounce words, phrases, or even individual sounds.
Sensory aphasia is characterized by a disorder of perception and understanding of speech and occurs when the superior gyrus of the temporal lobe (Wernicke's center) is damaged.
A distorted understanding of complex structures, phrases, and sentences is observed in patients with semantic aphasia. Patients with the disorder do not understand associations, metaphors, or space-time relationships.
In addition, there is total aphasia, a clinical form of pathology characterized by a disorder in the reproduction and understanding of oral speech.
Important! The method of recovery and the choice of speech therapy tactics are determined by the clinical variant of the pathology.
Additional impact of stroke on communication skills
Oral speech is the most common means of communication, which involves not only the participation of the vocal apparatus, but also the involvement of other mental and physical functions. Acute circulatory disorders cause the following changes:
- Emotional accompaniment of speech. Due to diffuse damage to higher mental functions in people after a stroke, uncontrolled changes in intonation often occur during a conversation.
- Sensory system disorders. Intermittent visual and hearing impairments make it difficult to adequately use oral and written language skills.
- Impaired memory and concentration. A stroke affects the functioning of short-term memory, so the frequent loss of the main idea of a conversation makes the communication process long and uninformative.
In addition, the cerebrovascular accident affects the mental spheres of the individual: emotions, mood and character traits, which also affects the patient’s communication skills.
Music therapy
Music affects many brain sectors at the same time, which allows it to “break through” to a person’s consciousness even when everything else does not work. Some patients after a stroke are not able to speak normally or pronounce individual words, but they manage to sing. In such situations, classes to restore lost speech in the format of singing are especially useful.
Music is good for returning to movement after a stroke. There are scientific reports that people who underwent rehabilitation with lessons in playing a musical instrument had changes in the activity of the sensory cortex of the brain and noticeably improved motor functions. Listening to music during the rehabilitation period is a useful activity that stimulates brain function.
In addition, music evokes a feeling of joy and relaxation. You can cope with severe stress or anxiety by listening to a calm tune. It is believed that this is very useful during the rehabilitation period after a stroke. Due to the inability to freely control their limbs, people often feel depressed and angry. A soothing melody will balance emotions, which will prevent psycho-emotional disorders.
Acupuncture
Acupuncture (acupuncture) is a popular technique of ancient Chinese medicine. It is based on stimulation of reflexogenic zones using special needles. Acupuncture is effective for both forms of stroke: ischemic and hemorrhagic. It may be prescribed if the patient has developed motor aphasia in order to improve the general condition of the body, stimulate cardiac and brain activity, and restore motor functions. Contraindications to the procedure are minimal: malignant neoplasms, acute infectious pathologies, epilepsy and exacerbation of chronic diseases.
The procedures are prescribed in courses of 6-10 sessions with a short interval. An individual treatment regimen is developed by a reflexologist.
Causes of the disease
This disease is caused by disorders that occur in one or another area of the cerebral cortex. Such an imbalance can be caused by both pathological changes in parts of the brain and the presence of a somatic disease.
The main causes of aphasia:
- Neoplasms in the head (tumors).
- Chronic or acute cerebrovascular accident (stroke).
- Various traumatic brain injuries.
- Presence of an abscess in the brain.
- Multiple sclerosis, encephalomyelitis. In these diseases, the myelin protein, which ensures the passage of nerve impulses through the fibers, disintegrates.
- Epilepsy, in which, due to sudden electrical discharges in the cerebral cortex, its normal functioning is disrupted.
- Disturbance of the structure of brain tissue. These include Alzheimer's disease, Pick's disease, Creutzfeldt-Jakob disease, etc.
- Other inflammatory diseases affecting the cerebral cortex.
In some cases, aphasia occurs as a complication of neurosurgical operations, poisoning with heavy poisons, and also as a result of chronic brain dysfunction.
People who have a genetic predisposition to the disease are at risk. The onset of the disease can be triggered by heart defects, chronic high blood pressure, rheumatism, and hemorrhages. Speech reproduction disorders are often observed in older people.
How long does it take to recover speech after a stroke?
The period of speech restoration, as a rule, begins 7-10 days after the stroke (possibly if the patient is in a stable condition). But sometimes there are situations when the patient is not able to start working with a speech therapist after 3-4 weeks. In any case, recovery should begin no later than after 6-8 weeks, otherwise it will be much more difficult to restore impaired functions.
Speech restoration as part of a rehabilitation program after a stroke is quite slow. Depending on the form of aphasia and the severity of the clinical case, it can take several weeks or even months. It often happens that articulation returns to the patient in spurts: for a long time, the exercises do not bring positive results, but one day the speech improves noticeably.
It is problematic to provide an accurate forecast for the timing of speech restoration in advance (individual for each patient). Rehabilitation is a strictly gradual and step-by-step process. The duration of all stages is individual for each patient: for some it takes several weeks, while for others it takes up to a year. As practice shows, in most patients, speech abilities noticeably improve 3-4 months after regular classes. However, the entire recovery period takes from 3 to 5 years.
How to restore the ability to speak in an adult after losing it?
How long it takes for speech function to recover depends on how severely the brain was damaged. Therefore, in some patients, the ability to speak is restored quite quickly (within a few weeks or months), while in others it takes years, and it is difficult to predict how long it will take.
To restore patients who have suffered a stroke, the following types of rehabilitation are used:
- Drug therapy.
- Classes with a speech therapist.
- Physiotherapy.
- Massage.
- Surgical intervention.
Medicines
During rehabilitation after a stroke, the doctor prescribes several groups of drugs to the patient that help reduce side effects, improve the condition and help the patient quickly return to their normal lifestyle:
- Muscle relaxants.
- Antidepressants.
- Anticonvulsants.
- Antiplatelet agents.
Muscle relaxants
On a note. In the third month after a stroke, the patient may develop muscle hypertonicity, which greatly slows down the rehabilitation process.
Then muscle relaxants are prescribed that can reduce excessive muscle tone. The best muscle relaxants for stroke:
- Sirdalud (cost in Moscow from 227, in St. Petersburg from 176).
- Tizalud (cost in Moscow from 160, in St. Petersburg from 125 rubles).
Antidepressant series drugs
Almost 80% of patients suffer from depression after a stroke, which slows down the recovery process. In this case, antidepressants are prescribed. The best antidepressants for stroke:
- Nortriptyline (cost in Moscow from 990, in St. Petersburg from 1,000 rubles).
- Paxil (cost in Moscow from 650, in St. Petersburg from 660 rubles).
Anticonvulsants
When seizures occur, anticonvulsants are prescribed, but they should be taken with caution, as this group of drugs can cause side effects. The best anticonvulsants for stroke:
- Finlepsin (cost in Moscow from 215, in St. Petersburg from 193 rubles).
- Convulex (cost in Moscow from 116, in St. Petersburg from 135 rubles).
Antiplatelet agents
If after a stroke the patient’s blood becomes more viscous, this slows down the recovery of brain tissue. In this case, the help of antiplatelet agents is required to prevent the formation of blood clots. The best antiplatelet drugs for stroke:
- Reopoliglyukin (cost in Moscow from 102, in St. Petersburg from 110 rubles).
- Clopidogrel (cost in Moscow from 226, in St. Petersburg from 205 rubles).
Important! Any medications should be prescribed only by the attending physician. Do not self-prescribe medications, otherwise this can only worsen the patient’s condition.
Medication alone does not provide much benefit, but it does help progress recovery when used with other types of therapy, such as speech therapy and physical therapy.
Classes with a speech therapist
At the first lesson, the speech therapist draws up a plan for each patient individually. The following exercises are required:
- Reading tongue twisters.
- Drawing.
- Mimic and speech therapy massage.
If all the specialist’s recommendations are carefully followed, about 20-30% of patients with moderate and severe speech disorders begin to speak normally by the time they are discharged from the hospital. Classes can also be held at home. The exercise program must be combined with medications, physical therapy and other types of rehabilitation.
Physiotherapy
This type of rehabilitation stimulates muscle recovery and helps to achieve better results from classes with a speech therapist and from taking medications.
- Magnetotherapy. This procedure stimulates all processes in the brain, and also improves the functioning of the endocrine and nervous systems. A rather painful method, but it is considered one of the most effective. The patient's condition improves after 2-3 weeks.
- Dorsanval. Prescribed for poor blood supply to the brain and limbs. After a whole course of procedures, which is at least 5-7 sessions that take place over 2-3 weeks, the patient’s condition improves significantly.
Massage
Therapeutic massage for stroke significantly improves blood supply to the affected tissues, which increases the flow of oxygen and other nutrients to them. In addition, massage helps relieve muscle and psychological tension. A therapeutic massage course usually consists of 10 sessions , but can be adjusted individually for each patient.
Note! A massage course can only be conducted by a qualified specialist with a medical education.
Surgery
A method such as surgery is resorted to in extreme cases, when other methods do not improve the patient’s condition and cannot restore lost speech. To restore speech, a neurosurgical operation is performed, which creates additional connections between healthy tissues and vessels in the speech area of the brain, without affecting the damaged areas.
Advantages of visiting the Yusupov Hospital
The main advantages include: our own staff of caregivers, the opportunity to stay with relatives, varied meals, round-the-clock supervision, classes for 5-6 hours a day.
Experienced specialists at the Yusupov Hospital practice treatment of speech loss due to stroke. A full diagnostic is preliminarily provided to identify the severity of disorders and assess the general state of health. For this purpose, modern equipment is often used (computed (CT) and magnetic resonance imaging (MRI) are prescribed).
According to the severity of the clinical case, doctors develop a suitable recovery method. Examinations are necessary both before starting treatment and for subsequent observation and monitoring of dynamics. The Yusupov Hospital staff includes experienced neurologists, speech therapists, massage therapists and exercise therapy instructors. Thanks to the highly qualified specialists and individual approach, it is possible to significantly reduce the length of stay in the inpatient department. To make an appointment, you can call the numbers listed on the website or leave a request online.