Description

Primary progressive aphasia (uh-FAY-zhuh) is a rare nervous system condition that affects a person's ability to communicate. People who have primary progressive aphasia may have difficulty expressing their thoughts and understanding or the search of words.

The symptoms develop gradually, often before the age of 65 years old. They get worse with time. People with primary progressive aphasia may lose the ability to speak and write. Finally, you are not able to understand written or spoken language.

This condition progresses slowly. People who have primary progressive aphasia can continue to take care of themselves and participate in the daily activities for several years.

Primary progressive aphasia is a type of frontotemporal dementia. Frontotemporal dementia is a set of conditions that are the result of the degeneration of the frontal or temporal lobes of the brain. These areas include the tissue of the brain involved in speech and language. Not all people with primary progressive aphasia have dementia, but the most of it. The term "dementia" is typically not used until a person can't do things alone, due to the changes in their thinking and understanding.

Symptoms

Primary progressive aphasia symptoms vary depending on which part of the brain language areas are involved. The condition has three types. Each type of cause different symptoms. The symptoms develop over time and gradually get worse.

Semantic variant of primary progressive aphasia

The symptoms include:

  • Difficulty understanding spoken or written language, especially the words.
  • The difficulty to understand the meaning of the words.
  • Not being able to name objects.
  • Problems of spelling of words, especially those not written of the way in which the sound is, as the word "yacht".

Logopenic variant of primary progressive aphasia

The symptoms include:

  • The difficulty in understanding the language spoken, in particular, the long sentences.
  • Pausing and hesitating to search for the words to speak.
  • Not be able to repeat sentences or phrases.

Nonfluent-agrammatic variant of primary progressive aphasia

The symptoms include:

  • Leaving words or putting words in the correct order on the written and oral language.
  • Problems in the comprehension of complex sentences.
  • Difficulty speaking. This includes errors of the sounds of speech, known as apraxia of speech.

Primary progressive apraxia of speech associated with primary progressive aphasia. However, people with this condition do not have problems with the language. Have trouble speaking. This includes errors of speech sounds or has problems pronouncing words quickly.

When to see a doctor

Consult your health care professional if you have any concerns about your ability to communicate. If you have a friend or family member who has the symptoms of primary progressive aphasia, talk with the person about your concerns. Offer to go with the person to see a health professional.

If the changes in the speech or communication shall come suddenly, call 911 or your local emergency number.

Causes

Primary progressive aphasia is caused by a contraction of certain areas of the brain, known as lobes. In the primary progressive aphasia, the frontal, temporal or parietal lobes are affected. When the areas of the brain shrink, is called atrophy. The atrophy caused by primary progressive aphasia occurs mainly in the left side of the brain. The affected areas are responsible for speech and language.

Atrophy is linked to the presence of certain proteins in the brain. The proteins can reduce brain activity or function.

Risk factors

Risk factors for primary progressive aphasia include:

  • Learning disabilities. People who had a childhood, learning disabilities, such as dyslexia may have an increased risk of developing primary progressive aphasia.
  • Certain changes in the genes. Although primary progressive aphasia most of the times happens at random, rare genetic changes have been associated with the disease. If other members of your family have had primary progressive aphasia, consider genetic testing to see if they are more likely to develop it.

Complications

People with primary progressive aphasia eventually lose the ability to speak and write. This can take from 3 to 15 years. People with the disease have the problem of understanding written and spoken language.

As the disease progresses, other mental abilities such as memory, planning and organization can be affected. Some people develop other symptoms such as problems with movement, balance, and swallowing. With these complications, people with the disease eventually need help with the day-to-day care.

People with primary progressive aphasia may also develop depression as the disease progresses. Other complications may include dull emotions such as to show no concern, lack of judgment or social behavior which is not appropriate.

Prevention

There is no known way to prevent primary progressive aphasia. However, you can keep your brain healthy by the GROWTH:

  • G et the quality of sleep.
  • R reduce stress.
  • S pen connections.
  • W ork out.
  • T ry new things.
  • H ealthy eating.

Diagnosis

For the diagnosis of primary progressive aphasia, a neurologist or a speech and language pathologist is likely that the review of the symptoms and the order of the tests.

The communication of the problems that get worse without a significant change in the thinking and behavior of 2 to 3 years are a hallmark of primary progressive aphasia.

Tests and procedures used to diagnose primary progressive aphasia can include:

Neurological examination

Health care professionals may perform a neurological exam, a speech-language assessment and a neuropsychological assessment. The extent of the evidence of speech, language comprehension and skills. Also the extent of its recognition and naming of objects, memories, and other factors.

The blood and bodily fluids of the tests

Your healthcare provider may order blood tests, or a lumbar puncture, also known as a lumbar puncture to detect possible infections or search for other medical conditions. Genetic testing can determine if you have changes in genes linked to the primary progressive aphasia or other neurological conditions.

The brain scans

A brain mri can help to diagnose the primary progressive aphasia. The test can detect reduction of specific areas of the brain. Magnetic resonance imaging can also detect cerebrovascular accidents, tumors, and other conditions that affect brain function.

You can also get a fluorodeoxyglucose positron emission tomography scan, also known as an FDG PET scan, which shows the function of the brain. This test may show changes in the way that the brain uses glucose in the areas that are related to language. You may also have other PET scan to detect the presence of certain proteins associated with Alzheimer's disease.

Treatment

Primary progressive aphasia cannot be cured, and there are no drugs to treat it. However, some therapies may help to improve or maintain their ability to communicate and manage your condition.

Speech and language therapy

Working with a speech-language pathologist, focusing primarily on ways to compensate for the loss of language skills, can be helpful. Although the speech and language therapy may not stop the progression of the condition, may help control your condition. The therapy may also slow down the progression of some of the symptoms. Your therapist may recommend that caregivers also assist you to appointments.

Physical and occupational therapy

If your symptoms affect the movement and balance, working with a physical therapist and an occupational therapist can help to manage the symptoms.

Coping and support

Losing the ability to communicate can be stressful and frustrating. This is true both for the person with primary progressive aphasia and for friends and family. If you are a caregiver of a person with primary progressive aphasia, taking these steps can help everyone cope:

  • Learn all you can about the condition.
  • The person with the condition to carry an identification card and other materials that may help to explain the situation to the others.
  • Give the person time to talk.
  • Speak slowly in a simple, adult, phrases and listen carefully.
  • Talk with the person with the condition is about how you can help.
  • Take care of your personal needs. Get enough rest and make time for social activities.

The members of the family might need to make long-term care options for the person with primary progressive aphasia. You may also need to plan for the person's finances and help to make legal decisions to prepare for the more severe stages of the disease. Start this process early so that the person with primary progressive aphasia may be involved.

Support groups may be offered to caregivers and people with primary progressive aphasia or related conditions. Ask your social worker or other members of your health care team about resources of the community, or support groups. Other sources of information include the National Aphasia Association and the Association for the Degeneration Frontotemporal.

Preparing for your appointment

If you are experiencing symptoms, you could start by seeing your primary healthcare professional. This person can refer you to a doctor trained in brain and nervous system conditions, known as a neurologist. You may also be referred to a speech-language pathologist.

What you can do

Here's some information to help you prepare for your appointment.

  • Be conscious of any thing you need to do ahead of time. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
  • Write down any symptoms you have, including those that do not seem to be related to the reason for which you scheduled the appointment.
  • Write important personal information, including major stresses or recent life changes.
  • Make a list of all the medicines, vitamins, and supplements you are taking and the dose.
  • Have a family member or friend. Sometimes it can be very difficult to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
  • Write questions to ask their health care team.

For the primary progressive aphasia, some questions may include:

  • What is likely causing my symptoms?
  • What tests do I need?
  • Is my condition likely temporary or permanent?
  • You should see a specialist?
  • Should I consider genetic testing?
  • Are there brochures or other printed material I can have? What sites do you recommend?
  • What is the best course of action?
  • There are other options to the primary approach you're suggesting?
  • I have other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • What is going to happen to me at the time?

Do not hesitate to ask other questions.

What to expect from your doctor

Your healthcare provider is likely to ask several questions, such as:

  • When did your symptoms begin?
  • What are the symptoms came first?
  • Has had a new symptom?
  • The symptoms come and gone, or has remained constant?
  • How bad are the symptoms?
  • The symptoms got worse?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Have other family members had similar conditions?
Symptoms and treatment of Primary progressive aphasia