transcortical motor afacia

transcourtical motor afacia (tii. emm. oo. aii.), jyala commissural dysphasia kinwa white matter dysphasia asehi mhanatat, too bhasha-pramukh golardhatil agravarti varchya pudhil bhagachya nukasanamule hoto. heey nuksan samanyatah cerebrovascular apghatamule (see. vhee. aii.) hote. tii. emm. oo. aii. chey vaishishtya mhanje samanyatah bhashanatil ghat, joou menduchya prabhavit bhagachya nishkriyatecha parinam aahe. jaree davya hatachya vyakti tyanchya davya kinwa ujavya golardhat, tyaa vyaktinusar, bhashechi karye karatat asey disun aale asale taree, davya golardhat samanyatah bhashechi karye kelee jaatat. bhashanachi suruvat karnyasathi aanee tee kayam thevanyasathi bhasha-pramukh golardhatil agravarti pudhil bhag aavashyak aahet. yamule, tii. emm. oo. aii. asalelya vyaktinna bolanyat aanee diksha ghenyat anekada adchan yete.
panlot kshetratil nuksan heey bhasha nirmiti kinwa aaklan yamadhye guntalelya menduchya bhaganna thet haanee pohochavat nahee; tyaeivaji, nuksan heey bhag menduchya urvarit bhagapasoon vegale karate. jarr pudhil bhagache nuksan jhaale asel tarr bhashechya vaparashi sambandhit karyakari karye anekada prabhavit hotat. bhasheshi sambandhit karyakari karyanmadhye bhasheche pratisad sakriy karane, vakyarachana (vyakaran) niyantrit karane aanee varnanatmak pravachan yancha samavesh hoto. yaa kshetrantil adchaninmule purak kamatarata udbhavu shakatat, jyat guntaguntichi vakye tayar karnyat adachani yetat, konate shabd yogyaritya vaparayache teey nivadane aanee sambhashanat bhashan suru karane yancha samavesh asato.
menduchya hanichi vyapti aanee sthan bhashechya karya vaishishtyanchya pramanat aanee vividhatevar parinam karel (i.eae. pudhil bhagache khol nuksan aanee/kinwa anek pradeshanmadhye nuksan bhashela mothya pramanat haanee pohochavel). jarr agravarti pudhil bhagatil jakham pureshi mothee asel aanee mageel pudhil bhagaparyant vistarli asel tarr ujavya hemiperasis kinwa ujavya bajucha ardhangvayu haah tii. emm. oo. aii. shhee juloo shakato.
afesiyache itar kahee prakar aahet jeey tmoashi sambandhit aahet. udaharanarth, adynamic afacia haah tmoacha eka prakar aahe jyache vaishishtya viral bhashan aahe. heey frontal lobmadhye karyakari karyamule hote. tmoashi sambandhit afesiyacha aanakhi eka prakar mhanje dynamic afacia. afesiyacha haah prakar asalelya rugnanna eka nikatata vikar houu shakato jyamadhye tyanna bhashik ghatak ekatra karnyat adchan yete. dynamic afesiyasathi, heey sarvat spasht hote jevha rugnala vakyachya staravar anukram karnyas sangitale jaate tarr itar afesiyasathi contiguty vikar dhwani kinwa shabd staravar disu shakato.
lakshane aanee chinhe.
tii. emm. oo. aii. chey vargikaran eka askhalit afacia mhanoon kele jaate, jyache vaishishtya mhanje bolanyache utpadan lakshaniyaritya qamee hote, parantu shravanshaktichi changli samaj asate. shravnendriya aaklan kaushalye abadhit rahatat kaaran arquate faciculus aanee varnikche kshetra bighadalele nahee. tii. emm. oo. aii. asalelya vyakti dekhil punaravruttichi changli kaushalye darshavtat aanee lamb, guntaguntichya vakyanchi sahajpane aanee trutishivay punaravrutti karoo shakatat. tathapi, utsfurt bhashanat anekada ardhangvayu (afesiyamule vikaranmule bhashan trutinchi eka vistrut shreni) asate. konatyahi sapeksh sanvadachya samarthyachi parva naan karata, tii. emm. oo. aii. asalelya vyakti samanyatah qamee sambhashanatmak bhagidar asatat. agravarti varchya pudhil bhagachya nukasanamule, tii. emm. oo. aii. asalelya lokanmadhye sambhashan suru karnyat aanee sambhalanyat kamatarata asate, jyamule bhashan utpadan qamee hote. tii. emm. oo. aii. asaleli vyakti kvachitach uchchar karoo shakate aanee samanyatah gup rahate. teey tayar karatat teey uchchar samanyatah fakt eka teey done shabd lamb asatat. tathapi, adhik sanrachit aanee andaj lavnyayogya parasparsanvadanmadhye, tii. emm. oo. aii. asalelya vyakti adhik askhalitpane aanee twarit pratisad detat. yavyatirikt, yaa vyakti tyanchya laksh aanee sahkaryane vaishishtyikrut aahet aanee anekada tyanche varnan karya-kendrit mhanoon kele jaate.
karane.
neurological imagingne asey darshavile aahe qee tii. emm. oo. aii. samanyatah davya kinwa bhasha-pramukh golardhatil perisilvian bhagatil agravarti varchya frontal lobchya infarctmule hoto. agravarti varishtha frontal lobala prefrontal cortex mhanoon olakhale jaate jeey maukhik bhashanachya aarambhasathi aanee kalpanesathi jababdar aahe. nukasanamule pramukh bhashanche jaale, broka aanee varnikeche kshetra aanee arquate faciculus prabhavit hott naheet. davya agravarti cerebral dhamani (aii. see. aii.) avarodh, menduche arbud, aaghatatmak menduchi dukhapat (tii. bii. aay.) kinwa pragatishil majjasansthesambandhi vikaranmule vikaranmule strokemule mendula dukhapat houu shakate.
nidan.
sandarbh chikitsak aanee bhashan-bhasha rogshastradnya (ess. ell. pii.) yanchyadvare tii. emm. oo. aii. chey nidan kele jaate. tamoache ekoon lakshan mhanje satat sankoch aanee viramansah askhalit, qamee, khandit pratidhvani aanee chikatiche bhashan. tii. emm. oo. aii. asalelya rugnanna bolanyachi suruvat karnyat aanee teey chaloo thevanyatahi adchan yete. tathapi, bolanyachi abhivyakti aanee shravanvishayak aaklan heey vaishishtyapurn rahile aahe. yaa chinhe aanee lakshananmadhye akhand punaravrutti hone heey tii. emm. oo. aii. chey vaishishtyapurn chinh aahe.
tii. emm. oo. aii., kinwa afesiyacha itar konatahi prakar, tapasani aanee moolyankan prakriyedvare olakhala jaato aanee nidan keela jaato. jevha afesiyacha sanshay yeto tevha ess. ell. pii. kinwa itar vyavsayikandvare tapasani kelee jaau shakate. tapasani afesiyache nidan karat nahee, tarr tee pudhil sarvasamaveshak mulyankanachya garajekade nirdesh karate. tapasanimadhye samanyatah tondi karye, bhashan nirmiti kaushalye, aaklan, lekhee aanee maukhik bhashecha vapar, sandnyanatmak sanvad, gilane aanee shravanshaktiche moolyankan samavisht asate. tapasani aanee moolyankan heey donhi rugnachya bhashik aanee sanskrutik farkambabat sanvedanshil asale pahijet. ekhadya vyaktichya tapasanimadhye afesiyachi lakshane disun aalyas sarvasamaveshak moolyankan karanyachi shifaras kelee jaeel. american speach-langways-hearing association (aii. ess. aii.) aanee jaagtik aarogya sanghatana (vhee. etch. oo.) margdarshak tattve aanee "karya, apangatva aanee aarogyache aantarrashtriy vargikaran" (aay. see. eff.) chaukatiantargat, sarvasamaveshak mulyankanat keval bhashan aanee bhashach navhe tarr sharirachi rachana aanee karyatil dosh, saha-rugna kamatarata, kriyakalap aanee sahbhagatil maryada aanee sandarbhatmak (paryavaraniy aanee vaiyaktik) ghatak dekhil samavisht aahet. moolyankan sthir (sadhyache karya) kinwa gatishil (chaloo) asoo shakate aanee moolyankan sadhane pramanit kinwa gair-pramanit kelee jaau shakatat. samanyatah, afesiyachya mulyankanat rugna itihasacha sangrah, rugnakadoon swayam-ahwal, maukhik-motor tapasani, bolalya gelelya aanee lekhee swarupat abhivyakti aanee grahansheel bhasheche moolyankan aanee rugnala madat karnare aanee rugnala yash midvoon denyamadhye yenare adthale olakhane yancha samavesh hoto. yaa mulyankanatun, ess. ell. pii. afeshiyacha prakar aanee rugnachi sanvadatmak takad aanee kamkuvatpana aanee tyanchya nidanamule tyanchya ekoon jivanachya gunavattevar kassa parinam houu shakato heey nirdharit karel.
upchar.
transcortical motor affacias serve prakarchya afesiyavar upchar sahasa bhashan-bhashetil pathologistdware dile jaatat. ess. ell. pii. vyaktichi bolanyachi aanee bhashechi kshamata aanee garajanchya aadhare vishisht upcharatmak kaame aanee uddishte nivadte. sarvasadharanpane tii. emm. oo. aii. asalelya vyaktinsathi, upcharanmadhye tyanchya majboot shravanvishayak aaklan aanee punaravrutti kaushalyancha fayda ghetala pahije aanee vyaktiche qamee jhalele bhashan aanee sambhashan suru karnyat aanee rakhanyatil adachani door kelya pahijet. afacia upcharanmadhil naveen sanshodhan afacia (ell. pii. aii. aii.) sathee jeevan sahbhag drushtikonacha fayda darshavit aahe jyamadhye vaiyaktik rugnala vishisht vastavik jivanatil paristhitinmadhye (mhanje.eae. paricharikanshi prabhavipane sanvad sadhane kinwa rojgar midvane). rugnachya vishisht garajanchya aadhare, slups vividh upchar upkram pradan karoo shakatat.
shabd punarprapti aanee prarambh karnyachya adachani sudharanyasathi, chikitsak sangharshache namkaran vaparu shakatat jyamadhye rugnala vividh vastoo aanee chitre naav denyas sangitale jaate. tivratenusar, teey vakya purn karanyachi kaame dekhil vaparu shakatat jyamadhye chikitsak antim shabd (oo) gahal asaleli vakye sangato aanee rugnane rikt jaaga bharavi ashee apeksha karato. maryadit sanshodhan asey suchavate qee davya bajula gair-pratikatmak avayavanchi halchal (i.eae. vakya tayar kartana) tablower dawa haat dabalyane shabdik prarambh vadhu shakato. davya jaaget davya hatacha vapar menduchya ujavya golardhat diksha yantranela uttejit karato, jee bhashesathi dekhil vaparali jaau shakate, jyamule vyaktinna uchch askhalitatene aanee adhik maukhik aarambhasah adhik vyakaranatmak vakye tayar karata yetat.
bolanyachi kshamata vadhavanyasathi, chikitsak chitrancha sanch deu shakato aanee rugnala chitrat asalelya ghatananche varnan kinwa tapshilvar sanganyas pravrutt karoo shakato. chikitsak bolalele kinwa lekhee shabd dekhil deu shakato aanee rugnala vakyatil shabd vaparnyas pravrutt karoo shakato. yavyatirikt, chikitsak rugnache anubhav, matey kinwa samanya dnyan yavar aadharit prashna vicharoo shakato aanee rugnala vakye kinwa vakyansah uttar denyas pravrutt karoo shakato. adhik jodalelya bhashanavar kaam karnyasathi, chikitsak rugnala sandwich banvine kinwa kapade dhune yasarkhya prakriyanche varnan karnyas sangu shakato. eka abhyasat asey aadhalun aale aahe qee vakyarachana prashikshan jyamadhye vakyanchi rachana adchanichya padanukramavar kelee jaate, vyakarandrushtya sampoorn uchchar aanee uchcharanmadhye laabh nirman karatat jeey naveen aanee achook mahitee yashasviritya sampreshit karatat.
sambhashan kaushalye sudharanyasathi, slip rugnala sanrachit sambhashanat guntavu shakatat jyamadhye rugnala yogya sambhashanatmak valane ghenyas, sambhashanacha vishay rakhanyas aanee yogya vakye tayar karnyas madat karnyasathi aadhar deela jaato. doctoranna anekada vyavharik margdarshak tattve pradan karane aavashyak asate jenekarun rugnachya pratikriya doctoranchya vinantichya palikade jaatil aanee tyamule doctor bahutansh bolanar naheet. sanshodhan asey darshavite qee sambhashan upcharpaddhati guntaguntichya uchcharanchi takkewari, kalpana vyakt karnyasathi uchcharanchi karyakshamta aanee adhik paramparik uttejana upcharpaddhativar bolanyat ghalavalela ekoon vel sudharu shakate.
rugnachya tyanchya naisargik vyavasthanmadhye karyatmak sanvad sadhanyachya kshamatet sudharana karnyasathi, ess. ell. pii. sanvadatmak vyavasthanmadhye tyanche yash vadhavanyasathi dhorane aanee tantre pradan karel (mhanje.eae. ashabdik sanvadasah bhashan purak karane). anekada tii. emm. oo. aii. saha saha askhalit bhashan aanee agramatismvar maat karnyasathi rugnanna madat karnyasathi qamee vakyarachana upcharpaddhatichya vaparas sanshodhan samarthan dete. kaaran aggramatism rugnachya vyakarandrushtya yogya vakye tayar karnyachya kshamates pratibandh karato, yaa prakarchya upcharanmadhye hii agrarmatic kamatarata qamee karane aanee sambhashanat adhik utpadak honyasathi vaparali jaanari bhasha sandesh pohochavat asatana rugnala bhashik sanrachana sulabh karnyas shikavane samavisht aahe.
yavyatirikt, teey sanrakshit sandnyanatmak aanee samajik karyancha vapar sulabh karoon rugnachya sambhashan kshamatanna aadhar denyasathi rugnachya sanvad bhagidaranna prashikshit karoo shakatat. afacia sansthetil afacia asalelya praudhansathi samarthit sambhashanasarkhya vividh bhagidar prashikshan karyakramanchya vaparas sanshodhan samarthan dete. yaa karyakramat, rugnachi kshamata manya karnyavar aanee tee kshamata prakat karnyat tyanna madat karnyavar laksh kendrit kele jaate. yogya velee 'mallah tumhala maheet aahe' asey mhanane, sandeshanna purak karnyasathi havbhav vaparane, parshvabhoomicha aavaj maryadit karane aanee pratisadasathi puresa vel dene, yaa dhorananmadhye samavisht aahe.
tantrikashastrachya drushtikonatun, sanshodhanat asey aadhalun aale aahe qee tondane ghetalelya dopamine agonist, bromocryptine, tii. emm. oo. aii. kinwa edenamic afacia sarkhya askhalit prakarchya afesiyasathi hastakshep kartana sakaratmak parinam pradan kele aahet. abhyasat asey aadhalun aale aahe qee bromocryptine majjatantunchya jaalyanmadhye vaadh kelee aahe jee bolanyachi askhalit vaishishtye asalelya vyaktinmadhye bolanyachya aarambhas madat karate.
serve prakarchya afesiyachya upcharansathi neuroplasticitycha fayda ghenyasathi, velecha, tivratecha, kalavadhicha aanee upcharachi punaravrutti vicharat ghetali pahije. sanshodhanat asey aadhalun aale aahe qee, dukhapatinantarchya suruvatichya tivra tappyat suru kelele afacia upchar, junat tappyat suru kelelya upcharanchya tulanet adhik prabhavi asatat. upcharachi tivrata aanee kalavadhichya sandarbhat, abhyasat asey nondavale gele aahe qee 2-3 mahinyanchya kalavadhit tivra saptahik upcharpaddhati (darr aathvadyala andaje 8 taas) deuun jastit jaast barey jhaale. itar sanshodhan asey darshavtat qee uchch tivratechya upcharanpeksha vitarit upchar adhik fayadeshir asoo shakatat. konate sarvottam aahe heey nirdharit karnyasathi adhik sanshodhanachi aavashyakta aahe, parantu asey aadhalu shakate qee upcharpaddhaticha aadarsh kalavadhi aanee tivrata rugna aanee tyanchya garjannusar badalat rahate.
purvasoochana.
afesiyachya itar prakaranchya sambandhat, tmoa qamee varanvar hoto, tyamule tyachya purvasuchanabaddal qamee mahitee aahe. sarvasadharanpane, afacia asalelya vyaktinmadhye, stroke kinwa dukhapatinantar 6 mahinyanchya aat bahutek punarprapti disun yete, jaree pudhil mahine kinwa varshant adhik punarprapti suru rahoo shakate. afaciala karanibhoot asalelya strokechya prakaranusar barey honyacha kalavadhi vegala disu shakato. ischemic strokemule, pahilya done aathvadyant barey hone sarvat jaast asate aanee nantar pragati sthir hoiparyant overtime qamee hote. raktasravi strokemule, rugna bahutekda pahilya kahee aathvadyant thodi sudharana darshavito aanee nantar teey sthir hoiparyant tulanene jalad barey hoto.
seema kshetrachya jakhama asalelya aath rugnanvar kelelya abhyasat, serve rugnanna strokenanter suruvatila transcortical mishra afacia jhaala. yapaiki teen rugna strokenanter kahee divasantach purnapane barey jhaale. adhik agravarti jakhama asalelya itar teen rugnansathi, tyancha afacia tii. emm. oo. aii. madhye rupantarit jhaala. abhyasatil serve sahbhaginni tyanchya strokenanter 18 mahinyanchya aat sampoorn bhasha kshamata parat midavali. heey tii. emm. oo. aii. asalelya rugnansathi sakaratmak dirghakalin purvasoochana suchavate. tathapi, serve rugnansathi asey asoo shakat nahee aanee heey nishkarsh drudh karnyasathi adhik sanshodhan aavashyak aahe. aanakhi eka abhyasat asey aadhalun aale aahe qee timoacha purvasoochana jakhamechya aakaramule prabhavit hote. lahan jakhmanmule samanyatah bolanyas vilamb hoto; tarr, mothya jakhmanmule bhashetil adhik khol vikrutee aanee amoort bhashechya kshamatanmadhye adchan nirman hote.
sanshodhanatun asey disun aale aahe qee upcharacha afesiyachya parinamanvar thet parinam hoto. upcharacha marg nivadatana aanee rognidan tharvatana upcharachi tivrata, kalavadhi aanee vel yaa sarvancha vichar karane aavashyak aahe. sarvasadharanpane, adhik tivratemule adhik sudharana hote. dirghakalin upcharanmule adhik kayamswarupi badal hotat. velenusar, atidakshatapurn upchar karnyasathi pureshi punarprapti naan jhalelya pranalisathi upchar khoop lavkar suru karane katheen asoo shakate, parantu khoop ushirane suru kelyane jyaa sandhimadhye sarvat jaast badal houu shakato tee sandhee gamavoo shakate. neuroplasticity, hii ekhadya aaghatjanak ghatanenantar swatahla punarrachit karanyachi menduchi naisargik kshamata, jevha upchar ekach velee velee ghatananshi jodale jaatat, laksh vedhoon ghetat, sakaratmak bhavnanmadhye guntavatat, punaravrutti karyancha vapar karatat aanee vyaktichya garjansathi vishisht asatat tevha sarvottam ghadate.
rognidanavar parinam nishchit itar ghatakanmadhye jakhameche sthan aanee thikan yancha samavesh hoto. tii. emm. oo. aii. madhye parinami jakham samanyatah panlot kshetrat hote aanee tyat samanya bhasha kshamatesathi jababdar asalelya menduchya bhagancha thet samavesh nasato, yaa rugnansathi nidan ekandarit changle aahe. rugnache nidan nishchit nishchit itar ghatakanmadhye vay, strokepoorviche shikshan, ling, prerana aanee aadhar yancha samavesh hoto.
sandarbh.
<bii. aar.>

