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Transcortical Motor Aphasia Symptoms, Causes, Speech Therapy, Treatment

Commissural dysphasia and white motor dysphasia are the other names of transcortical motor aphasia. It is a speech disorder which occurs due to damage in anterior superior frontal lobe. It specifically occurs in language control center of hemisphere (frontal lobe). Usually left hemisphere of brain is involved in controlling language center. In this disease, patient can't speak openly I.e. there is reduced speech output.

It is difficult for patient to maintain his speech and initiation. Watershed region of brain is not involved in the direct harm of language production and comprehension center. Executive functions of language are affected if frontal lobe is damage.

Transcortical Motor Aphasia Symptoms



Transcortical motor aphasia is a speech disorder in which patient cant speak properly. He cannot even start a conversation and further maintain it. Executive functions of language are affected which mainly involve Grammer (Syntex) control, patient can't narrate a story or any thing he wants to and language response center is not properly activated. Other symptoms involve:

  • Patient find it hard to compose a sentence and elaborate it properly. 
  • Patient gets confused and cannot select right words during his speech. 
  • Starting a conversation is a hardest task for patient suffering from transcortical motor aphasia. 


Transcortical Motor Aphasia Symptoms, Causes, Speech Therapy, Treatment

Transcortical Motor Aphasia Causes


Transcortical motor aphasia occurs due to damage in the frontal lobe of brain. Frontal lobe specifically left hemisphere contains language control center. Usually damage in anterior superior frontal lobe is responsible for transcortical motor aphasia. This damage occurs due to cerebrovascular problem I.e. infarction. Prefrontal cortex is the part which involves ideation and initiation of verbal speech. So when damage occurs, it becomes difficult to initiate a conversation. Damage in anterior superior frontal lobe does not affect major language network, Broca's and Wernicke area and arcuate fasiculus. Only infarction is not the reason, damage can also occur due to stroke.

Transcortical Motor Aphasia Treatment


Treatment of transcortical motor aphasia involves speech therapy. Its treatment mainly focus on patients strong hearing conversation and skills of repetition and correcting the reduced speech output of patient. Treatment also covers maintenance of speech and initiation of speech including language. Participation approach to aphasia is a treatment  strategy which have greater success rates. In this treatment strategy, patient is asked to focus on his skills he required to talk with people. He is allowed to talk with people in real life situations like talking to nurse about anything he wants to.

Transcortical Motor Aphasia Speech Therapy


A speech and language pathologist is required for treating transcortical motor aphasia. In this therapy some pictures are provided to patient and ask him to elaborate every single thing or event happening in this picture. Pathologist also provide a vocabulary booklet so that he can easily choose words to start his speech. Other than pictures, pathologist also ask some questions related to current affairs, patients past life, general knowledge and about his experiences. He also ask patient about some cooking recipes like baking a cake and cookies. Repetitive questioning helps in improvement of patients speech.
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Sclerosing Encapsulating Peritonitis Definition, Symptoms, Causes, Treatment

It is a pathological condition in which a small bowel is encapsulated in the fibrocollagenous membrane. This encasement may be total or partial. Sclerosing encapsulating peritonitis is considered one of the cause behind acute or sub-acute small bowl obstruction. Talking about the term sclerosing encapsulating peritonitis, it was originally termed as abdominal cocoon. Other names for sclerosing encapsulating peritonitis are encapsulating peritonitis, sclerosing peritonitis and peritonitis chronica fibrosa incapsulata. It is basically the inflammation of peritoneal cavity with fatal outcome.


The peritoneal dialysis treatment is the major risk factor of sclerosing encapsulating peritonitis. There may be many other reasons behind it like liver or renal transplantation and secondary to any drug treatment. Sclerosing encapsulating peritonitis involves both the visceral and parietal surfaces of abdominal cavity. It is a slow disease process and have low incidence. Dialysis of peritoneal cavity is the major risk factor associated with sclerosing encapsulating peritonitis.

The peritoneal membrane may become structurally and functionally damage. People having peritoneal dialysis for more than 4 to 5 years may develop sclerosing encapsulating peritonitis. It is a rarely occurring disease with main complication i.e. peritoneal dialysis. The incidence of occurrence of sclerosing encapsulating peritonitis is about 0.7 to 3.3 percent. It has high mortality rate i.e. more than 50 percent.

Sclerosing Encapsulating Peritonitis Definition, Symptoms, Causes, Treatment

Sclerosing Encapsulating Peritonitis Symptoms


Sclerosing encapsulating peritonitis is a rare but fatal condition. Patient may experience symptoms related to bowel. As a small part of bowel is encapsulated with a fibrous sheet or we can say membrane. This membrane causes various complications. There may be obstruction of bowel due to encapsulation. Mural fibrosis with anorexia is a symptom. Nausea and vomiting are the common symptoms of sclerosing encapsulating peritonitis. These symptoms often leads to malnutrition. This is a fatal condition because when patient will not able to digest something, then patient may suffer from malnutrition and eventually die.

Sclerosing Encapsulating Peritonitis Causes


Sclerosing encapsulating peritonitis may occur secondary to some conditions or may be idiopathic. It may occur secondary to some drug treatment like practolol, chronic ambulatory peritoneal dialysis and ventriculoperitoneal and peritoneovenous shunts. Other causes may include familial Mediterranean fever, sarcoidosis, liver transplantation, tuberculosis, gastrointestinal malignancy and fibrogenic foreign material. Other than these common causes, there is a rare cause i.e. luteinised ovarian thecomas. Usually patients having peritoneal dialysis for more than 4 to 5 years develop sclerosing encapsulating peritonitis easily and it may prove fatal for patient.

Sclerosing Encapsulating Peritonitis Treatment


Talking about the treatment of sclerosing encapsulating peritonitis, surgical procedure is recommended. Laparotomy is performed to check the severity of condition. Then most suitable surgical procedure is recommended like adhesiolysis and segmental resection. In addition to treatment therapy, peritoneal dialysis should be replaced with hemodialysis to avoid further complications.

Total parental nutrition TPN is recommended to relax bowel. As it helps a lot in relieving symptoms. Medications involve methotrexate and corticosteroids which help in treatment. Tamoxifen is also used for sclerosing encapsulating peritonitis. If bowel obstruction is diagnosed, then surgery is recommended. But the mortality rate is higher that's why it is risky.
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