Logorrhea : Causes, Symptoms, Diagnosis & Treatment

• Causes Of Logorrhea
• Acoustic-Gnostic Aphasia
• Sensory Alalia
• Psychoneurological Disorders
• Other Reasons
• Diagnostics
• Treatment
• Correction Of Sensory Alalia
• Correction Of Acoustic-Gnostic Aphasia
• Treatment Of Mental Disorders

Logorrhea is a specific speech disorder, consisting in uncontrolled incoherent speech production. Senseless, unregulated verbosity is combined with an accelerated pace of speech. The symptom is typical for sensory alalia, acoustic-gnostic aphasia, schizophrenia, manic disorder, dementia, etc. Diagnosis of logorrhea is carried out by speech therapists, psychiatrists as part of the main speech or mental disorder. Depending on the cause of verbosity, speech therapy correction or drug treatment may be carried out.

The term "logorrhea" (from the Greek "logos" - word" and "rhoia" - expiration) in translation means "verbal flow". Synonyms - polyphasia, verbal salad, verbal okroshka, speech incontinence. Sometimes this concept is used in the meaning of "idle talk", "chatter" in relation to various kinds of speakers, speakers, advertising agents, behind the verbosity of which there is a commercial interest (to sell a service, product, to give out maximum information in a short period of time). In medicine, logorrhea occurs in a number of pathological conditions studied in speech therapy and clinical psychiatry.

Causes of logorrhea

Acoustic-gnostic aphasia

A patient with a sensory form of aphasia talks a lot, but is unintelligible. Speech production gives the impression of a meaningless stream of words, unrelated sentences. At the same time, speech does not have articulation difficulties, it is well intoned. Such verbosity is explained by a violation of auditory attention and auditory control. Words lose their constant meaning. The patient does not understand the meaning of the sounding speech: neither his own, nor those around him.

sensory alalia

Auditory agnosia also underlies sensory alalia. Children have increased speech activity, but their speech is incoherent, consists of a set of interjections, parts of words, sound combinations. Along with logorrhea, numerous echolalia, perseverations, paraphasias, and contamination are observed. The sound-syllabic structure of the word is distorted.

The meaning of the word is unstable, as is its form. Speech is meaningless and incomprehensible to others. Verbal production is supplemented by mimic and articulatory movements. There is no criticism of his speech.

Psychoneurological disorders

Logorrhea occurs not only in speech pathologies, but also in a number of mental disorders. This phenomenon is present in the clinical picture of the following conditions:

• Schizophrenia. This group of patients is characterized by a peculiar speech disorder - schizophasia - conducting a meaningless monologue, often with delusional content. In severe cases, schizophasia can turn into logorrhea. Speech becomes incoherent, consists of an empty set of words and fragments of phrases, replete with neologisms. There is a syntactic simplification, a violation of grammar, a frequent and unreasonable change in the topic of conversation.
• Bipolar affective disorder. Increased verbal activity - logorrhea - is noted in patients with manic psychosis. Typical symptoms: an accelerated pace of speech, loudness of voice, "jumps of thoughts", inconsistency and incoherence of presentation. For others, the speech of patients becomes incomprehensible.
• Senile dementia. Logorrhea occurs in the initial phase of senile dementia. The patients' speech is lively, intoned, with expressive gestures and facial expressions. However, due to the impoverishment of the vocabulary, spontaneous speech becomes incoherent, with a large number of stereotypes, verbal paraphasias. The patient quickly loses the outline of the conversation, switches from one topic to another.
• Frontal Syndrome. Increased speech production is observed in patients with the disinhibited type of the syndrome. The patient cannot control spontaneous speech, gets stuck on the previous fragments of the statement. Oral speech is replete with clichés, stereotypes, echolalic repetitions.

Logorrhea

Other reasons

Speech disinhibition of the "speech salad" type can be observed as a transient phenomenon in some mentally healthy people. So, a kind of logorrhea was noted in people who were isolated for a long time (living away from other people, prisoners, staying in solitary confinement, etc.). When an interlocutor appears, such people begin to speak quickly, inconsistently, switching from one thought to another, I lose the logic of the story.

Nonsense in speech is found in people who are intoxicated. A drunk person can talk “about nothing” for a long time, often repeating himself, contradicting himself, reacting inadequately to the words of others.

Diagnostics

Logorrhea is detected as part of the diagnosis of the underlying neurological or psychiatric syndrome. Given the disease, the patient may need to consult a neurologist, psychiatrist, speech therapist, neuropsychologist. Assigned diagnostic methods:

• Clinical and anamnestic examination. It is carried out by medical specialists as part of the initial appointment. Complaints and the reasons that caused the disease are clarified, an analysis of the symptoms is carried out. The mental status of the patient is assessed. Based on the data obtained, the leading syndrome is identified.
• Instrumental diagnostics. It is necessary for organic lesions of the brain, as well as for the purpose of differential diagnosis of neurological and mental disorders. Brain MRI, EEG, echoencephalography are prescribed.
• Logopedic examination. Required for patients with logorrhea due to alalia, aphasia. Speech status is assessed: impressive and expressive speech, phonemic processes, the state of written speech, counting. In aphasia, it is important to study automated and non-automated speech, understanding lexico-grammatical structures .
• Neuropsychological testing. Various types of gnosis (auditory, visual, somato-sensory), praxis (oral, digital, constructive, symbolic) are being studied. With the help of observation, special tests, scales and questionnaires, the characteristics of the behavior, thinking, attention, and cognitive functions of the patient are studied.

Treatment

There is no specific treatment for logorrhea. Speech and other pathological symptoms decrease or disappear with the treatment of the causative disease. In some cases, pharmacotherapy is necessary, in others, speech therapy and neuropsychological correction is required.

Correction of sensory alalia

The purpose of logopedic influence in logorrhea is the development of auditory perception and understanding of addressed speech. In this case, it is important to use all safe analyzers. With sensory alalia, the following areas of corrective action are implemented:

• distinguishing non-speech sounds: the sound of water, the rustle of paper, the sound of metal, the sound of toys and musical instruments;
• discrimination and differentiation of speech sounds;
• formation of a connection between the sound image of a word and a specific object or phenomenon;
• developing understanding of verbal instructions;
• development of auditory control over one's own speech;
• literacy training.

Classes with a neuropsychologist are shown. In their work, specialists use sensory integration methods: sand therapy, aromatherapy, modeling from plasticine and clay, tactile toys, classes in the sensory room, etc. Fitball gymnastics, vibration massage are useful.

Correction of acoustic-gnostic aphasia

Speech rehabilitation of patients with sensory aphasia is carried out against the background of pharmacotherapy (nootropics, neurometabolites). Clinical psychologists and exercise therapy instructors deal with patients. Logotherapy aims to:

• inhibition of unproductive speech - logorrhea;
• activation of auditory attention and control;
• restoration of the semantic meaning of the word;
• differentiated perception of speech sounds based on articulation, graphic symbols.

As the understanding of addressed and own speech improves, uncontrolled speech activity decreases in patients, logorrhea is overcome.

Correction of acoustic-gnostic aphasia

Treatment of mental disorders

The goal of therapy is to stabilize or slow down the progression of the pathological process. The main method is lifelong drug therapy. In various forms of dementia, acetylcholinesterase inhibitors and NMDA antagonists are prescribed, in BAD - normothymic drugs, SSRIs.

Antipsychotic drugs are the mainstay of treatment for schizophrenia. During the period of remission, social rehabilitation measures are connected: cognitive trainings, social skills trainings, counseling of family members, etc.