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May 16, 2019

ESOC-2019

SCREENING FOR APHASIA IN STROKE – NEED FOR DETAILED LANGUAGE EVALUATION?

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aphasia

diagnosis

screening tool

nihss

language testing

Abstract

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Abstract

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Keywords

aphasia

diagnosis

screening tool

nihss

language testing

Abstract

Background and Aims: An efficient tool to identify aphasia in stroke is imperative to facilitate patient communication, treatment and rehabilitation. Screening tools must be quick and easy to perform but may be insufficient in detecting aphasia. We investigated how well the two screening tools, the National Institutes of Health Stroke Scale (NIHSS) sub-item 9 and the Language Screening Tool (LAST) could detect aphasia compared with the detailed language test Comprehensive Aphasia Test (CAT). Methods: 211 patients with first-ever acute ischemic stroke were consecutively included prospectively in the Lund Stroke Register Study and screened for aphasia. Patients with aphasia in the acute phase after stroke (day 2-7, n=62) according to NIHSS item 9 and/or LAST were re-assessed 4-6 weeks post stroke with NIHSS item 9, LAST and CAT (total n=52; n=7 deceased, n=3 drop-out). In addition, 55 control subjects without stroke nor aphasia were assessed with CAT. Results: 39 of 52 patients were diagnosed with remaining aphasia 4-6 weeks post stroke according to CAT in comparison to 29 patients according to LAST and 26 patients according to NIHSS item 9. Word finding difficulties and reading comprehension were the most common aphasia symptoms (86% and 71%), however word finding difficulties were also present in 10% of the subjects in the control group. Conclusions: A detailed language test detects more patients with remaining aphasia compared to screening tests. Screening tools for aphasia may underestimate the incidence of aphasia.

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© Copyright 2019 Morressier GmbH.
All rights reserved.