17. Crossed Aphasia
• lesion in the right hemisphere in a right-handed
individual.
• Occurs in 1-2% of all aphasias, and characterised
by confusion, memory and attention defects, and
personality change (in addition to the usual
language deficits).
• Agrammatism is common, but comprehension
and naming tend to be preserved.
20. Apraxia of speech(AOS)
• neurogenic communication disorder affecting
the motor programming system for speech
production.
• By the definition of apraxia, AOS only affects
volitional(willful or purposeful) movement
patterns, however in AOS usually also
automatic speech is affected
21. • Stroke-associated AOS is the most common
form of acquired AOS, making up about 60%
of all reported acquired AOS cases.
• Individuals with acquired AOS demonstrate
hallmark characteristics of articulation and
prosody (rhythm, stress or intonation) errors.
22. Apraxia of speech
the following five speech characteristics that an individual with apraxia
of speech may exhibit:
•Effortful trial and error with groping 常出現搜尋構音動作
•Self correction of errors 自我糾正
•Abnormal rhythm, stress and intonation 講話語暢不順
•Inconsistent articulation errors on repeated speech productions of
the same utterance 構音錯誤不一致
•Difficulty initiating utterances 啟動困難
43. • Dysphagia (difficulty swallowing) has an overall prevalence of 25–
65% in stroke patients:
– 67% of brainstem strokes
– 28% of all left hemispheric strokes
– 21% of all right hemispheric strokes
• More common in bilateral hemisphere lesions than in unilateral
hemisphere lesions.
• More common in large-vessel than in small-vessel strokes.
• Delayed pharyngeal swallow is the most common cause (Veis,
1985).
44. • 下列何種姿勢可以最有效地改善中風偏癱病人
的吞嚥障礙(dysphagia)?(94-1-94)
1.將頭部前傾、下巴收攏(chin tuck)
2.將頭部轉向健側邊(turning the head to the
stronger side)
3.將頭部傾向患側邊(tilting the head toward the
affected side)
4.將頭部後仰,下巴前伸(neck extension)
49. • Compensatory Strategies
– Chin tuck: provides airway protection by
preventing entry of liquid into the larynx
– Head rotation: Turn the head to the paretic side.
– Head tilt: uses gravity to guide bolus into
ipsilateral pharynx.
50. • Compensatory Strategies
– Supraglottic swallow: concomitant breath holding and
swallowing closes the vocal folds to protect the
trachea.
– Super supraglottic swallow: adds Valsalva maneuver
to maximize vocal fold closing.
– Mendelsohn maneuver: patient voluntarily holds the
larynx at its maximal height to lengthen duration of
cricopharyngeal opening.