AFAZIJA

987 Comments / Logoped za odrasle

Afazija je stečeni poremećaj komunikacije, uzrokovan oštećenjem mozga, koji se manifestuje deficitom na fonološkom, leksičkom , gramatičkom, semantičkom i pragmatičkom planu, kako u procesu produkcije tako i u razumevanju jezika. Uzrokuje i kognitivne deficite kao što su : deficiti pažnje, pamćenja i mišljenja, svesno delovanje i shvatanje okoline. Afazične osobe imaju smanjenu mogućnost izražavanja i razumevanja reči kao i onoga što one predstavljaju. Do ovog poremećaja došlo je usled oštećenja centara za govor u mozgu, kortikalnih i subkortikalnih struktura. Potrebno je uraditi detaljno ispitivanje i neuropsihološko testiranje , a prognoza stanja veoma zavisi od uzroka i obima oštećenja .

UZROCI AFAZIJA :

Najčešći uzrok afazija jeste moždani udar, a mogu biti i tumori, traume , degenerativne bolesti CNS-a , povrede glave , udarac ili infekcija. Učestalost afazija kod cerebrovaskularnih oboljenja ( tranzitorni ishemički atak, tromboza, hemoragija, embolija, arterioskleroza ) kreće se oko 21-33%, a kod povreda glave 16-50 %.

SIMPTOMI AFAZIJA :

Afazija ne uključuje razvojne poremećaje jezika .

Neki od simptoma afazije u zavisnosti od mesta moždane lezije mogu biti :

  • Anomija ( oštećenje sposobnosti imenovanja )
  • Parafazija ( upotreba neodgovarajućih reči u govoru )
  • Agramatizam ( gramatički neadekvatna formulacija i produkcija rečenica )
  • Cirkumlokucija ( zaobilazni govor koga karakteriše preterana upotreba semantički ’’ praznih reči’’, npr. ono, to, nešto, stvar…)
  • Žargon ( produkcija iskaza bez značenja )
  • Verbalni stereotipi ( nevoljna produkcija pojedinih reči ili fraza )
  • Poremećaj spontanog govora ( potpuno odsustvo ili oštećena inicijacija spontane govorne aktivnosti )
  • Poremećaj auditivnog razumevanja ( ovi poremećaji se kreću od skoro potpunog odsustva sposobnosti razumevanja kada pacijent ne reaguje na sopstveno ime niti je u stanju da izvši najjednostavniji nalog).
  • Aleksija ( poremećaj čitanja )
  • Agrafija ( poremećaj pisanja )
  • Akalkulija ( poremećaj računanja )
  • Perseveracije (nnevoljno ponavljanje jednog jezičkog izraza )
  • Anozognozija ( odsustvo uvida u sopstveni deficit ).

Potrebno je naglasiti da slučaj afazije nije isključiv, retko je prisutna samo afazija. Uz afaziju se mogu javiti i : paraliza određenih mišića, gubitak vida u nekom delu vidnog polja, gubitak uvida na koji način treba završiti započetu radnju, npr. obući se, poteškoće u gutanju hrane i pića tj. u kontroli mišića usta, problemi sa pamćenjem, otežana kontrola emocija, epilepsija usled stvaranja ožiljka oštećenog područja. Navedeni simptomi se mogu ali ne moraju javljati zajedno sa afazijom. Važno je razlikovati afaziju od govornih poremećaja uzrokovanih određenim poremećajem u razvoju kao i oštećenja motorike mišića ( dizartrija i disfonija ).

Dijagnoza se postavlja na osnovu detaljnog i temeljnog testiranja i primene kompletne baterije testova za afazije, kao i na osnovu neurološkog pregleda deteta ili odrasle osobe.

TRETMAN AFAZIJA

Tretmane sprovodi logoped . Sa tretmanima treba početi što pre, odmah nakon otpuštanja iz bolnice jer čekanje negativno deluje na oporavak funkcije govora . Tokom tretmana radi se na poboljšavanju komunikativnih sposobnosti, osposobljavanju funkcije razumevanja govora, poboljšavanju ponavljanja odr. radnje, razvoj i restitucija neverbalnih sposobnosti. U tretmanima , pored stručne pomoći logopeda ključnu ulogu imaju i članovi porodice jer bez njih je tretman nezamisliv. Saradnja članova porodice mora biti stalna, oni moraju biti istrajni kako bi pomogli svom članu porodice. Neophodno je da se tretmani sprovode bez prekida i da članovi porodice u kućnim uslovima samostalno sprovode sve usmene i pismene vežbe koje pacijent vežba na seansama kod logopeda i da kontinuirano vodi dnevnik svakodnevnih aktivnosti.

 

 

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