Disturbances of speech and language in patients aroused from long-term coma subsequent to traumatic brain injury.

Background. The purpose of this study was to characterize the speech and language disturbances seen in patients with traumatic brain injury aroused from long-term coma at the Rehabilitation Clinic of the Bydgoszcz Academy of Medicine. Material and methods. The research covered 94 patients (30 women, 64 men, average age 34.7). Speech and language disturbances were diagnosed with basic neuropsychological batteries and authorial methods, and classified as akinetic mutism, global aphasia, sensory aphasia, motor aphasia, dysarthria, or dysphonia. The patients were examined 3 times: at admission, after one month, and after two months. Results. The patients displayed various speech and language disturbances. In the first examination, 47 persons (50.0%) presented with dysarthria. Post-traumatic aphasia was seen in 28 persons (29.8%). Akinetic mutism was somewhat less common (12 persons, 12.8%) and dysphonia least common (6 persons, 6.3%). In the second examination there were numerous shifts between groups, and 15 persons no longer had any disturbances (16.0%). These trends continued in the third examination. Dysphonia was seen in 4 persons (4.3%), akinetic mutism in only 3 (3.2%). 23 persons (24.5%) did not show any speech and language disturbances. Conclusions. Patients aroused from long-term coma display various speech and language disturbances. A significant number have dysarthria and/or aphasia, somewhat fewer have akinetic mutism. Dysphonia is also seen. Mutism often resolves spontaneously, as does dysphonia, while the symptoms of aphasia and dysarthria are more persistent.