1425 - Atypical Presentation of Bilingual Aphasia After a Basal Ganglia Stroke: A Case Report

Case Diagnosis: Bilingual-Aphasia After a Basal-Ganglia Stroke

Case Description: Patient is a 66year old Polish female with a past medical history significant for hypertension who presented to the hospital with acute right sided weakness found to have left sided basal ganglia hemorrhage without midline shift. Patient was treated with mannitol along with 2%saline, sodium tablets and Keppra daily for seizure prophylaxis. Patient was found to have expressive aphasia and right sided weakness. Patient’s primary language was Polish and after the stroke, patient kept switching between English and Polish words when conversing with family without realizing. The patient was admitted to acute inpatient rehab consisting of physical, occupational therapy and speech therapy in which the patient made significant improvement.

Discussions: Aphasia is the loss or impairment of language abilities caused by damage to language-processing areas in the brain, typically in the left-hemisphere. This leads to difficulties in formulating, retrieving, or understanding language symbols.The brain-injury can affect both languages, and the extent and type of language deficits may vary between the languages. Bilingual-Aphasia can result in language-interference and code-switching during communication in which the person mixes elements from both languages unintentionally. Parallel Bilingual-Aphasia occurs when both languages are equally affected, and the person experiences similar language deficits in each language. Selective Bilingual-Aphasia in which one language is more impaired than the other. Mixed Bilingual-Aphasia is a combination of symptoms from parallel and selective aphasia in which both languages are impacted, but one language may still be more severely affected.

Conclusions: Speech-language therapy plays a critical role in the rehabilitation of Bilingual-Aphasia. Language recovery is influenced by age of language acquisition, the extent of brain damage, and the individual's language use post-injury. Understanding how the brain adapts to bilingual aphasia can inform rehabilitation strategies and potentially lead to better outcomes for individuals with language impairments in a multilingual context.