Paragrammatism: symptoms, causes and treatment

Language is a tool that we use daily to communicate… But what happens when it is altered? Are we aware of what this implies? If we have a brain injury, a stroke, a head injury, an infectious disease of the brain... it is possible that we develop some type of aphasia.

Among the aphasias, we find Broca's aphasia, which is characterized mainly because spontaneous language is altered (it is not fluent). Besides, also implies another great symptom: paragrammatism. In this article we will know what exactly it consists of, its symptoms, its causes and possible treatments for it.

• Related article: "The 14 types of language disorders"

Paragrammatism: what is it?

Paragrammatism, also called asyntaxia or telegraphic language, consists of an alteration of verbal expression (that is, from spoken language), typically manifested in motor aphasias (also called Broca's aphasias).

Its main symptom is the appearance, in the speech of the speaker, of syntactically disorganized sentences, coupled with the use of incorrect grammatical forms when structuring sentences.

Thus, it implies the appearance, in speech, of grammatical errors, and the use of an incorrect time mark in verbs. People with paragrammatism also use pronouns inappropriately. All these mistakes occur in the context of a wide range of grammatical constructions.

In severe cases of paragrammatism, the patient's speech becomes fully intelligible. Thus, in these cases, jargon also appears, which consists of a language disorder through which the person substitutes the appropriate words for unintelligible terms.

Broca's aphasia

As we have seen, paragrammatism appears in the Broca's aphasia. Broca's aphasia implies, at the brain level, that the third frontal gyrus is injured (that is, Brodmann areas 44 and 45). The main symptoms of this type of aphasia, beyond paragrammatism, are:

• A spontaneous language not fluent
• The altered name
• A preserved understanding
• Altered repetition

Examples

To better understand this alteration, some examples of phrases from people with paragrammatism are: "I trust you a lot" or "On Thursday you fail, we are going to eat six friends."

Symptoms

The main symptoms of paragrammatism are as follows.

1. Errors in the order of words and sequences

The first symptom of paragrammatism is a sequence of errors that appear when ordering words and sequences, at a syntactic and / or morphological level.

Thus, people with paragrammatism tend to replace the order of the sentences with a set of phrases, which at first In view they may seem well structured, but in reality they are not, since there is no coordination or logical connection between they.

2. Exaggeratedly long sentences

Another symptom of paragrammatism is an exaggerated length in sentences. In fact, said length is related to two other alterations: jargon (already commented) and verbiage. In this case, verbiage implies the excessive use of words when speaking, which can become a true alteration in the flow of language, on a quantitative level.

In addition, the verbiage is accompanied by other symptoms, such as the prolixity of the speech, the acceleration in it and the difficulties to be interrupted.

On the other hand, in the same statement that the person emits, various changes in the communicative thread may appear, which make their language incomprehensible.

3. Substitution of some words

Another symptom is the substitution of certain types of words for others; this occurs with functional words or inflectional affixes. Thus these are replaced by other words belonging to the same semantic field.

Neologisms may also appear, with similarities to the functional word being replaced. For their part, neologisms are "made up words", as well as newly created expressions, within a language.

4. Difficulties adapting the sentences

Another symptom of this language alteration, also common, is great difficulty adapting the different sentences to the existing context.

• You may be interested: "The 6 types of aphasia (causes, symptoms and characteristics)"

Causes

The main cause of paragrammatism is Broca's aphasia, one of the existing types of aphasia. Aphasias are the loss of language function, and originate from an organic lesion of the brain.

There are multiple types of aphasia. In turn, the causes of aphasia can be various. Some of the most frequent are:

1. Head Trauma (TBI)

One of the possible causes of aphasia, which in turn causes paragrammatism, is a Head Trauma (TBI).

A TCE consists of an injury often caused by a blow to the head, which involves brain involvement; If this affectation covers the areas responsible for language, an aphasia occurs.

2. Brain tumor

Brain tumors can also cause aphasias, if they press on the area (or areas) of the brain responsible for language.

Tumors can be primary (if they originate in the brain tissue itself), or produced by metastasis (which is when a malignant tumor has spread to another part of the body).

3. Cerebrovascular accident (CVA) or stroke

These occur when the blood supply to the brain is interrupted (or when it decreases), which means that the brain cannot oxygenate itself for a few seconds. What happens many times is that certain groups of neurons die.

Stroke can be hemorrhagic or ischemic. It is estimated that approximately 40% of people who have suffered a stroke or stroke suffer from aphasia.

4. Infectious diseases

Infectious diseases can also cause aphasias, although they are usually temporary aphasias, since when the infection disappears, so does the aphasia. Examples of this type of disease are: encephalitis, meningitis or brain abscess.

5. Degenerative diseases

Finally, degenerative diseases can also lead to aphasia and this, in turn, to paragrammatism. Examples of this type of disease are: Alzheimer's, Pick... Aging is usually the cause of this type of disease.

Treatment

The treatment of paragrammatism implies the treatment of aphasia as a global picture. Mainly, you choose to perform a neurorehabilitation treatment; that is, cognitive rehabilitation, which involves a series of exercises, activities and tasks that allow language and communication to be worked on.

On the other hand also a speech therapy treatment is used to work the affected areas by aphasia, and in the present case, the alterations derived from paragrammatism.

Thus, exercises are used that allow, for example, to work the sequences of sentences at the level morphological and syntactic, which require ordering sentences, filling in the missing gaps, discriminating sounds, etc.

Logically, each treatment will be personalized to the type of patient and injury.

Bibliographic references:

• Alexander M.P. (1997). Aphasia: clinical and anatomic aspects. In: Feinberg TE and Farah MJ Eds. Behavioral Neurology and Neuropsychology. Mc Graw Hill, New York; 133-149.
• Belloch, A., Sandín, B. and Ramos, F. (2010). Manual of Psychopathology. Volume I and II. Madrid: McGraw-Hill.
• Borregón Sanz, S. and González Calvo, A. (2000). Aphasia Exploration, diagnosis and treatment. Madrid: CEPE. (2nd edition).
• Pérez- Pamies, M., Manero, R. Mª and Bertrán-Serra, I. (2001). Aphasias In Peña Casanova, J. Speech Therapy Manual. Barcelona: Masson. (pp. 369-407).