Évolution à long terme dˈune aphasie non fluente sévère. Intérêt dˈune rééducation prolongée

Abstract

INTRODUCTION: Long-term clinical outcome of severe non-fluent aphasia is poorly reported. The efficacy of intensive speech therapy has been previously demonstrated but not the efficacy of prolonged speech rehabilitation . METHOD: We report a single case of aphasia, with a description of the initial clinical features and the long term outcome . Moreover we discuss the rehabilitation efficacy in two situations : delayed rehabilitation and long-lasting rehabilitation. RESULTS: A young adult was admitted after fronto-temporal cerebral infarction and presented with a severe non fluent aphasia. Spontaneous recovery involved comprehension but not verbal expression. Speech therapy began 10 months after onset and an improvement of oral expression was observed during at least 6 years. DISCUSSION: This case illustrates long term-recovery patterns of aphasia and the efficacy of delayed speech therapy, and moreover its efficacy at a long time after onset. No rehabilitation was performed during the period of spontaneous recovery. Consequently recovery of spontaneous oral expression can be attributed to speech rehabilitation. Furthermore long-lasting improvement can also be attributed to prolonged rehabilitation. Total amount of speech therapy for the patient can be similar to the amount of efficacious intensive therapy previously described. CONCLUSION: These findings confirm the efficacy of speech therapy in the late stage of recovery, and the possibility of late improvement after stroke.