Expressive Aphasia - Presentation

Presentation

Sufferers of this form of aphasia exhibit the common problem of agrammatism. For them, speech is difficult to initiate, non-fluent, labored, and halting. Writing is difficult, as well. Intonation and stress patterns are deficient. Language is reduced to disjointed words, and sentence construction is poor, omitting function words and inflections (bound morphemes). A person with expressive aphasia might say "Son ... University ... Smart ... Good ... Good ... "

For example, in the following passage, a Broca's aphasic patient is trying to explain how he came to the hospital for dental surgery:

Yes... ah... Monday... er... Dad and Peter H... (his own name), and Dad.... er... hospital... and ah... Wednesday... Wednesday, nine o'clock... and oh... Thursday... ten o'clock, ah doctors... two... an' doctors... and er... teeth... yah.

Patients who communicated with sign language before the onset of the aphasia experience analogous symptoms.

Severity of expressive aphasia varies among patients. In the most extreme cases, patients may be able to produce only a single word. The most famous case of this was Paul Broca's patient Leborgne, nicknamed "Tan", after the only syllable he could say. Even in such cases, over-learned and rote-learned speech patterns may be retained—for instance, some patients can count from one to ten, but cannot produce the same numbers in ordinary conversation.

While, in general, word comprehension is preserved, meaning interpretation dependent on syntax and phrase structure is substantially impaired. This can be demonstrated by using phrases with unusual structures. A typical Broca's aphasic patient will misinterpret "the dog is bitten by the man" by switching the subject and object. Note this element is a problem with receptive language, not expressive language, and is one reason why the problem is referred to as agrammatic aphasia.

Patients who recover go on to say that they knew what they wanted to say but could not express themselves. Residual deficits will often be seen.